老年痛风患者血尿酸水平与亚临床甲状腺功能减退症关系研究

Analysis of the correlation between serum uric acid levels and thyroid hormones among hospitalized elderly gout patients

目的探讨老年痛风患者血尿酸水平与亚临床甲状腺功能减退症关系。方法回顾性分析2014年4月至2019年12月天津医科大学朱宪彝纪念医院痛风科住院治疗的老年痛风患者646例,男性616例、女性30例,年龄(68.8±5.1)岁。收集患者临床资料和生化指标,将尿酸水平分为四分位,分析其与甲状腺激素水平的关系。结果随尿酸水平升高,体质指数、肥胖患病率、脂代谢紊乱患病率、脂肪肝患病率、发作关节数、总胆固醇、低密度脂蛋白、三酰甘油和胰岛素抵抗指数均呈升高趋势(P<0.01);尿酸排泄分数呈下降趋势(P<0.05);老年痛风发生亚临床甲状腺功能减退患病率为11.3%(73例),随尿酸水平升高,亚临床甲状腺功能减退的患病率呈升高趋势,以血尿酸四分位分组[Q1组(<417.8μmol/L)162例、Q2组(417.8~501.7μmol/L)158例、Q3组(501.8~517.0μmol/L)163例、Q4组(>517.0μmol/L)163例],亚临床甲状腺功能减退患病率分别为9.3%(15例)、12.0%(19例)、11.0%(18例)、14.7%(24例),组间比较差异无统计学意义(F=9.42,P>0.05)。随尿酸水平升高,游离三碘甲状腺原氨酸呈升高趋势(P<0.01),游离甲状腺素呈下降趋势(P<0.05)。结论亚临床甲状腺功能减退症患病率随血尿酸升高而升高,血尿酸升高及多重代谢紊乱是老年痛风患者发生亚临床甲状腺功能减退症的重要影响因素。

Objective To investigate the correlation between serum uric acid levels and thyroid hormones in hospitalized elderly gout patients.Methods A total of 646 hospitalized gout patients,including 616 males and 30 females,aged(68.8±5.1)years,who were hospitalized at the Department of Gout,Chu Hsien-I Memorial Hospital from April 2014 to December 2019,were retrospectively analyzed.Clinical information was collected and relevant biochemical tests were conducted.Serum uric acid(SUA)levels were divided into quartiles and their associations with thyroid hormone levels were analyzed.Results With the increase of SUA,body mass index,the prevalence of obesity,the prevalence of dyslipidemia,and the prevalence of fatty liver,the number of involved joints,cholesterol,low-density lipoprotein cholesterol,triacylglycerol,and homeostasis model assessment trended upward significantly(P<0.05);FUA showed a downward trend(F=9.42,P>0.05).The prevalence of subclinical hypothyroidism in older patients was 11.3%(73 cases).With the increase of SUA,the prevalence of subclinical hypothyroidism and free triiodothyronine levels showed an upward trend,whereas free thyroxine levels showed a downward trend(P<0.01).Conclusions In elderly gout patients,the prevalence of subclinical hypothyroidism increases with SUA levels.Hyperuricemia and multiple metabolic disorders are independent risk factors for subclinical hypothyroidism in these patients.