The Relationship Between Different Fractional Excretion Of Uric Acid And Gout Attacks And The Analysis Of Related Factors

Objective1.Explore the correlation between FEUA and patient gender,age,BMI and biochemical indicators,and find the main factors affecting FEUA;2.To compare the biochemical data of different FEUA and the proportion of acute gout attacks,and determine the relationship between FEUA and acute gout attack;3.To compare the differences in FEUA between the acute and non-acute groups,and analyze the possible influencing factors.Method1.A total of 425 patients were enrolled in the 24-hour urine biochemical examination at Kaiping Central Hospital from January 2015 to May 2019.Using<2015Gout Classification Criteria:An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative>to be the classification criteria of gout and acute gout attack.Exclusion criteria:tumor diseases,secondary hyperuricemia,eGFR is less than 30ml*min^-1*1.73m^-2,hematological diseases and patients who have taken benzbromarone or cyclosporine recently.A total of 142 patients qualified for this study were enrolled2.Patient's gender,age,height and weight,blood pressure,detect total cholesterol?TC?,triglyceride?TG?,blood uric acid?SUA?,fasting blood glucose?FPG?,serum creatinine?Scr?,BUN,Pa CO₂,urine volume,the urine p H value were tested,Urine p H,urinary albumin was detected by random urine.According to the test standard,patients should have low purine diet more than 2 days at least.After emptying the bladder at 7o'clock in the morning,start collecting urine specimens until 7 o'clock the next day so that we can collect total urine in the past 24 hours.Then uric acid?UUA?,Urinary creatinine?Ucr?,The uric acid excretion fraction?FEUA?,glomerular filtration rate?eGFR?,and endogenous muscle clearance?CCR?were calculated.3.Statistical analysis was performed using SPSS 19.0 software.The gender was analyzed byc²test,the non-parametric test was used to analyze the age,and the one-way ANOVA was used to analyze the BMI.The measurement data conforms to the normal distribution and is represented by`x±s,those does not conform to the normal distribution and is represented by median?interquartile range?indicates,and use Wilcoxon test.Count data is expressed in number of cases?or percentage?,and the comparison between groups was performed using thec²test.One-way ANOVA was used to analyze the relationship between different groups and clinical data,and P<0.05is a relevant indicator.Use logistic regression analysis to analyze the correlation between the relevant indicators and groups?grouped by different FEUA types,or whether acute gout attacks?.P<0.05 was considered statistically significant for differences or correlations.Result1.There were significant differences in age?P<0.01?and gender?P=0.031?among the three groups of different FEUA types.The age of patients in poor excretion group was lower than that of the other two groups,while the average of the mixed group and overproduced group were lower.The age is relevant.Men in poor excretion group were significantly more than women,and the proportion of mixed group men and women were similar;male patients were mainly in poor excretion group,and female patients were mainly in mixed group.There was no significant difference in BMI?P=0.114?.2.Among the four factors of the FEUA calculation formula,Scr,Ucr and SUA can affect the FEUA classification,and the correlation is in accordance with the FEUA calculation formula.In addition,FEUA was positively correlated with age and BUN,and negatively correlated with eGFR and CCR?P<0.05?.Age has some differences in the three groups,but it does not affect the FEUA.The eGFR and CCR of patients with poor excretion were significantly higher than those of the other two groups,while the difference of eGFR and CCR between patients with mixed group and overproduction group was not significant.3.Patients with hypertension or diabetes are mainly in the poor excretion group and mixed group,but the three groups have no significant difference.Patients without hypertension or diabetes mainly in the poor excretion group.Patients with hypertension and diabetes had significantly higher FEUA than those with neither hypertension nor diabetes.4.Ucr,SUA,and Scr were significantly higher in patients with acute gout attack than non-acute groups,and males account for the majority.But FPG,eGFR,CCR is lower than non-acute groups.Ucr significantly affected acute gout attacks?P<0.05,B=0.199?and was positively correlated.FPG can significantly affect acute gout attacks?P<0.05,B=-0.167?,indicating that the higher the blood glucose,the lower the probability of acute gout attack.Conclusion1.The study found that FEUA is related to age and gender;the poor excretion group is younger and more male than the other groups;male patients mainly in the poor excretion group,while female patients mainly in the mixed group.2.The study found that,except for the three factors of FEUA formula?Scr,Ucr and SUA?can affect FEUA classification,the other indicators can not significantly affect FEUA classification.There was no significant difference between urine p H,BUN,TC,TG,Pa CO₂ and different uric acid excretion groups,as well as acute gout attack or not.3.Although Ucr was positively correlated with acute gout attacks,FEUA was not significantly correlated with acute gout attacks,suggesting that there was no clear linear relationship between Ucr and FEUA and acute gout attacks.4.Ucr is a factor that can affect acute gout attack,but its possible mechanism remains to be further studied.