Analysis of risk factors related to early hyperuricemia and gout in morbid obesity patients after laparoscopic sleeve gastrectomy
10.3760/cma.j.cn115807-20240603-00184
- VernacularTitle:病态性肥胖患者腹腔镜胃袖状切除术后早期高尿酸血症与痛风相关危险因素分析
- Author:
Yitong HAN
1
;
Tiantian YANG
1
;
Junhang CHEN
1
;
Yan CHEN
1
;
Xiaoyu LIANG
1
;
Longhao SUN
1
Author Information
1. 天津医科大学总医院普通外科，天津 300052
- Publication Type:Journal Article
- Keywords:
Laparoscopic sleeve gastrectomy;
Hyperuricemia;
Gout;
Morbid obesity
- From:
Chinese Journal of Endocrine Surgery
2024;18(6):779-783
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors associated with early hyperuricemia and gout attacks following laparoscopic sleeve gastrectomy (LSG) .Methods:This study was a retrospective observational study. Obese patients who underwent LSG surgery at Tianjin Medical University General Hospital from Jan. 2022 to Jul. 2023 were included according to inclusion and exclusion criteria. General information, body composition data, and laboratory tests were collected preoperatively and at one month postoperatively.Results:This study included a total of 300 patients. ①During the postoperative follow-up period, 216 out of 300 patients developed hyperuricemia, and 14 patients experienced gout attacks. ②Analysis of risk factors for early hyperuricemia revealed that male gender ( OR=5.32, 95% CI=1.953-14.489), postoperative creatinine ( OR=1.031, 95% CI=1.005-1.058), and preoperative uric acid levels ( OR=1.01, 95% CI=1.005-1.014) were independent risk factors for early hyperuricemia after laparoscopic sleeve gastrectomy (LSG). The area under the ROC curve (AUC) for the logistic regression model diagnosing hyperuricemia was 0.803 (95% CI=0.752-0.853), with sensitivity and specificity of 72.2% and 78.6%, respectively. ③Analysis of risk factors for early gout attacks showed that a history of gout ( OR=11.464, 95% CI=1.755-74.873), male gender ( OR=161.895, 95% CI=13.469-1946.022), postoperative fluid ratio ( OR=0.702, 95% CI=0.554-0.889), and changes in uric acid levels ( OR=1.017, 95% CI=1.006-1.028) were independent risk factors for early gout attacks after LSG. The AUC for the logistic regression model diagnosing gout was 0.921 (95% CI=0.808-1), with sensitivity and specificity of 93.4% and 92.9%, respectively. Conclusions:The incidence of early postoperative hyperuricemia is high, whereas the incidence of gout is low after LSG. Gender, preoperative uric acid, and postoperative creatinine are independent risk factors for hyperuricemia after LSG. History of gout, gender, postoperative water ratio, and change in uric acid levels are independent risk factors for gout after LSG.
