广西痛风患者膳食模式与痛风石相关性研究

Correlation between dietary patterns and gouty tophus in patients with gout in Guangxi

目的探讨广西农村地区痛风患者的膳食模式,分析其与痛风石患病风险的关系。方法利用2015-2016年广西痛风发病危险因素调查的379例痛风病例数据,将调查中的痛风患者根据是否有痛风石分为痛风石组(128例)和无痛风石组(251例),所有痛风患者既往食物消费量根据《中国居民膳食指南2016》推荐摄入量及实际情况进行分层,采用单因素和多因素非条件logistic回归分析方法,比较分析两组人群的膳食结构和生活方式的差异。结果无痛风石痛风病例的主食、鱼类摄入量高于痛风石组(均P<0.05)。在校正了性别、职业、吸烟、痛风家族史、血尿酸水平、蔬菜、水果、畜禽肉类、蛋类、内脏和酒精摄入量因素后,壮族、痛风病程≥6年和≥9年均可增加痛风石的患病风险,OR(95%CI)分别为3.08(1.58~5.98)、3.67(1.59~8.49)和3.84(1.87~7.87);当主食摄入量≥250 g/d和水果摄入量≥100 g/d时均可降低痛风石的患病风险,OR(95%CI)分别为0.46(0.24~0.87)、0.31(0.13~0.77)。结论广西农村地区壮族、长病程(病程达6年以上者)是痛风石患病的危险因素,适量增加主食和水果摄入量可降低痛风患者罹患痛风石的风险。

Objective To investigate the dietary patterns of gout patients in rural areas of Guangxi, and to analyze its relation- ship with the susceptibility to gouty tophus. Methods The data based on survey of the risk factors of gout in 379 gout cases in Guangxi from 2015 to 2016 were collected in this study. The gout patients were divided into gouty tophus group （ n = 128） and gout without tophus group （n= 251 ）. All the gout patients＇ food consumption in the past was stratified according to the recommended nutrient intake （RNI） from Dietary Guidelines for Chinese Residents （2016） and the actual situation, gnivariate and muhivariable unconditional logistic regression analyses were used to compare the differences in dietary patterns and lifestyles between the two groups. Results The intake of staple food and fish was higher in the gout without tophus group than in the gouty tophus group （both P〈0.05）. After being adjusted by gender, occupation, smoking, family history of gout, serum uric acid level and intake of vegetables, fruits, meat of livestock and poultry, eggs, gut and alcohol, Zhnang ethnieity （ OR（95%CI） = 3.08（1.58-5.98） ）, gout course ≥ 6 （0R（95%CI） = 3.67（1.59-8.49）） and ≥ 9 years （0R（95%CI） = 3.84（1.87-7.87）） could increase the risk for gouty tophi, while staple food intake ≥ 250 g/d （0R（95%CI） = 0.46（0.24-0.87） ） and fruit intake 〉1 100 g/d （ OR （95%CI） = 0.31（0.13-0.77） ） significantly decreased the risk for gouty tophi. Conclusions Zhuang ethnicity and long course of gout （ ≥ 6 years） in rural areas of Guangxi are risk factors for gouty tophi. Appropriately increasing intake of staple food and fruits can decrease the risk.