Objective:To explore the effect of triglycerides on gout flares and rate of achieving the target serum urate during the initial phase of urate-lowering therapy.Methods:In this prospective cohort study, male gout patients who visited the Gout Specialty Clinic of the Affiliated Hospital of Qingdao University from September 2021 to January 2024 were recruited. After a 2-week washout period with medication cessation and a low-purine diet, eligible participants were stratified into normal triglyceride group and hypertriglyceridemia group according to baseline triglyceride levels. All patients initiated uric acid-lowering therapy with febuxostat 20 mg once daily. For patients whose serum uric acid remained >360 μmol/L at 4 weeks, the dose was increased to 40 mg once daily. Follow-ups were conducted every 4 weeks for 12 weeks. Primary outcomes included gout flare frequency, serum uric acid target achievement rate, and changes in liver function.Results:A total of 557 gout patients were included in this study, including 266 in the normal triglyceride group and 291 in the hypertriglyceridemia group. During the initial phase of urate-lowering therapy, the rate(54.0% vs 44.4%, P=0.030) and frequency( P=0.028) of gout flares in the hypertriglyceridemia group were significantly higher compared with normal triglyceride group. Flare rate in the hypertriglyceridemia group was significantly higher(36.1% vs 25.2%, P=0.007) at week 0-4, but not during weeks 4-12.After urate-lowering therapy, the rate of achieving the target serum urate<360 μmol/L in hypertriglyceridemia group was significantly lower than normal triglyceride group(41.9% vs 52.6%, P=0.015). The incidence of alanine aminotransferase(ALT) or aspartate aminotransferase(AST) elevation greater than 2 times in hypertriglyceridemia group was significantly higher than that in normal triglyceride group(8.9% vs 2.6%, P=0.003). Conclusion:Hypertriglyceridemia significantly increases the risk of gout flares, reduces serum uric acid target achievement rates, and raises the likelihood of liver dysfunction during initial uric acid-lowering therapy in male gout patients.

Objective:To investigate whether dual-energy computed tomography(DECT) measurement of monosodium urate(MSU) crystal loading can predict the risk of gout flares.Methods:A single-center, prospective, observational study included 229 gout patients initially diagnosed at the Gout Clinic of Qingdao University from August 2021 to February 2022. The patients underwent MSU assessment of the bilateral feet using DECT. Following enrolment, all patients commenced uric acid-lowering therapy(ULT) and were followed up at 3 and 6 months. Patients who experienced at least one flare within 6 months were compared with those who did not, and the odds ratio( OR) for the risk of gout flares was calculated. Results:Patients who experienced gout flare had a significantly longer disease duration[(6.69±5.42) vs(4.14±4.86) years, P<0.01], a higher number of flares in the past year(4.80±1.73 vs 2.02±1. 23, P<0.01), a higher proportion of fatty livers(11.0% vs 1.4%, P<0.05), and a greater volume of MSU crystals in the feet[(3.52±9.74) vs(0.29±0.98)cm 3,P<0.05] compared to patients without gout flare. The results of the multifactorial logistic regression analysis indicated that the number of flares in the past year( OR=1.295, 95% CI 1.032-1.613, P<0.05) and feet MSU crystal volume( OR=3.245, 95% CI 1.164-9.064, P<0.05) were independent risk factors for gout flares. The receiver operating characteristic(ROC) curve indicated the integration of the MSU prediction model into the clinical prediction model resulted in a comprehensive prediction model with an area under curve(AUC) value of 0.780(95% CI 0.710-0.840), sensitivity of 0.83, and specificity of 0.62. Internal validation of the comprehensive prediction model using the Bootstrap method yielded a C-index of 0.770(95% CI 0.701-0.833) for predicting flares. The calibration curve of the model demonstrated a good fit between the predicted probability of flares and the actual probability, indicating high calibration accuracy. Conclusion:The volume of MSU crystals in the feet is an independent risk factor for flares following ULT. A larger volume of MSU crystals in the foot increases the likelihood of a flare. This study provides a basis for early prediction of flare and a reference for early preventive treatment.

Objective:To explore the effect of triglycerides on gout flares and rate of achieving the target serum urate during the initial phase of urate-lowering therapy.Methods:In this prospective cohort study, male gout patients who visited the Gout Specialty Clinic of the Affiliated Hospital of Qingdao University from September 2021 to January 2024 were recruited. After a 2-week washout period with medication cessation and a low-purine diet, eligible participants were stratified into normal triglyceride group and hypertriglyceridemia group according to baseline triglyceride levels. All patients initiated uric acid-lowering therapy with febuxostat 20 mg once daily. For patients whose serum uric acid remained >360 μmol/L at 4 weeks, the dose was increased to 40 mg once daily. Follow-ups were conducted every 4 weeks for 12 weeks. Primary outcomes included gout flare frequency, serum uric acid target achievement rate, and changes in liver function.Results:A total of 557 gout patients were included in this study, including 266 in the normal triglyceride group and 291 in the hypertriglyceridemia group. During the initial phase of urate-lowering therapy, the rate(54.0% vs 44.4%, P=0.030) and frequency( P=0.028) of gout flares in the hypertriglyceridemia group were significantly higher compared with normal triglyceride group. Flare rate in the hypertriglyceridemia group was significantly higher(36.1% vs 25.2%, P=0.007) at week 0-4, but not during weeks 4-12.After urate-lowering therapy, the rate of achieving the target serum urate<360 μmol/L in hypertriglyceridemia group was significantly lower than normal triglyceride group(41.9% vs 52.6%, P=0.015). The incidence of alanine aminotransferase(ALT) or aspartate aminotransferase(AST) elevation greater than 2 times in hypertriglyceridemia group was significantly higher than that in normal triglyceride group(8.9% vs 2.6%, P=0.003). Conclusion:Hypertriglyceridemia significantly increases the risk of gout flares, reduces serum uric acid target achievement rates, and raises the likelihood of liver dysfunction during initial uric acid-lowering therapy in male gout patients.

Objective:To explore the role of transgelin(TAGLN) in the occurrence and development of papillary thyroid carcinoma (PTC) and its possible signal pathway.Methods:One hundred cases of PTC tissues and corresponding paracancerous normal thyroid tissues were collected. Realtime quantitative PCR (RT-qPCR), Western blotting, and immunohistochemistry were used to analyze the expression of TAGLN in PTC tissues and corresponding paracancerous normal thyroid tissues. PTC cells were transfected with plasmid and shRNA lentivirus vector respectively to up-regulate or down-regulate the expression of TAGLN in order to detect the effects of them on the proliferation, invasion, and migration by cell proliferation assay(cell counting kit-8, CCK-8)and cell invasion and migration assays (Transwell). The effects of TAGLN on mitogen-activated protein kinase (MAPK)/extracellular-signal regulating kinase (ERK) signal pathway was detected with Western blotting.Results:RT-qPCR showed that there was no difference in the expression of TAGLN mRNA between PTC and corresponding paracancerous normal thyroid tissues ( P>0.05); Western blotting demonstrated that the expression of TAGLN protein in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues ( P<0.01). Immunohistochemical results revealed that the expression of TAGLN in PTC tissues was significantly lower than that in corresponding paracancerous normal thyroid tissues. Overexpression of TAGLN inhibited the proliferation, invasion, and migration of PTC cells ( P<0.01), but knockdown of TAGLN promoted the proliferation, invasion, and migration of PTC cells ( P<0.01). Overexpression of TAGLN decreased the expression of phosphorylated ERK ( P<0.05), whereas silencing TAGLN increased phosphorylated ERK level in PTC cells( P<0.01). Conclusion:The expression of TAGLN in PTC is significantly decreased. It is related to the occurrence and development of PTC, and its mechanism may be related to MAPK/ERK signal pathway.

Objective:This study aimed to evaluate the accuracy of a portable REF-XT01 uric acid meter in measuring blood uric acid concentration, and to determine whether the results of the uric acid meter could be used to guide the adjustment of uric acid-lowering drugs.Methods:1 551 subjects were enrolled from the Gout Clinical Medical Center of the Affiliated Hospital of Qingdao University. The fasting venous blood was collected and the serum uric acid was measured by an automatic biochemical analyzer. Meanwhile, the capillary blood uric acid was measured by fingertip puncture using the REF-XT01 uric acid meter. Linear regression, intra-group correlation coefficient(ICC), and Bland-Altman plots were used to analyze the uric acid concentration correlation between the biochemical analyzer(sUA BA)and the uric acid meter(sUA UM). The receiver operating characteristic curve(ROC curve)was conducted to evaluate whether sUA UM can be used as a reference for the gout patients to take uric acid-lowering drugs. Results:The regression analysis showed correlation between sUA BA and sUA UM, with the regression formula Y=0.875X+ 39.525( r=0.84, P<0.01)and the ICC was 0.829(95% CI 0.814-0.844, P<0.01). The Bland-Altman diagram showed a good consistence(the absolute deviation was-143.4-114.5 μmol/L, mean deviation was -14.4 μmol/L)between sUA BA and sUA UM. The sensitivity was 96.61%, specificity was 48.81%, and the area under the ROC curve(AUC)was 0.926( P<0.01)when 300 μmol/L was defined as the detection threshold of the uric acid meter, the sensitivity was 90.98%, specificity was 66.78%, and the area under the ROC curve(AUC)was 0.914( P<0.01)when 360 μmol/L was defined as the detection threshold of the uric acid meter. Conclusion:REF-XT01 uric acid meter is applicable for the adjustment of uric acid-lowering drugs for the gout patients, because of its high accuracy for the detection of uric acid.