| Objective:To explore the change and risk factors of thyroid hormones levels in primary gout/hyperuricemia, and the role of leptin between the two diseases.Methods:1.40primary gout patients and45hyperuricemia patients were selected, who were admitted or diagnosed in Tianjin Medical University Metabolic Diseases Hospital during Mar.2011to Aug.2011;27physical examination people were selected as the control group who participated the health examination during the same time.2. Records the following informations of the control, gout and hyperuricemia groups:(1) Demographic data:Age, Sex;(2) General physical examination informations:①height, weight, and body mass index was calculated (BMI=weight/height2,kg/m2);②systolic blood ptessure (SBP), diastolic blood ptessure (DBP);③comorbidity:overweight or obese, diabetes mellitus, hyperlipidemia, hypertension, and so on;(3) Laboratory parameters:①Biochemical indicators:serum uric acid (SUA), creatinine (Scr), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and creatinine clearance rate (Ccr) was calculated;②Indexs of thyroid function:thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4);③fasting plasma glucose (FPG), fasting insulin (FINS), the steady-state model method was used in calculating insulin resistance index (HOMA-IR)=FPG×FINS/22.5;④human serum leptin.3. Grouping:(1) control group, gout group and hyperuricemia group were divided into four groups again, according to the quartile of SUA level, each groups obtain28patients, and SUA level were as follows:164μmol/L<SUA≤344μmol/L,344μ mol/L<SUA t≤383.9u mol/L,383.9u mol/L<SUA≤446.85μmol/L,446.85u mol/L<SUA≤911.30μmol/L;(2) gout and hyperuricemia groups were divided into≤55years group and>55years group;(3) gout and hyperuricemia groups were divided into male group and female group;Results:1. The positive rate of subclinical hypothyroidism in gout and hyperuricemia groups were7.5%,13.33%respectively.significantly higher than normal group(0%);2. Comparing with the control group, the positive rate of overweight or obese, hypertension, metabolic syndrome were significantly increased, and BMI, SBP, TG, CHO, TSH, FINS, HOMA-IR, leptin were increased, and FT4was decreased in the gout and hyperuricemia groups(P<0.05);3. As uric acid levels rise, the positive rate of metabolic syndrome, the level of TSH, HOMA-IR, leptin were increased, and FT3, FT4were decreased;4. In hyperuricemia group, comparing with the≤55years group, gender, SUA, TSH, HOMA-IR were increased and FT4was decreased in>55years group;5. In gout group, the positive rate of subclinical hypothyroidism in femal group was higher than male group, the levels of CHO, FINS, HOMA-IR were decreased and TSH was increased in female group;6. In gout and hyperuricemia groups, TSH level was positively correlated with age, BMI, SUA, Ccr, FT4, leptin (linear correlation coefficient were0.699、0.946、0.948、0.322、0.650、0.754、0.728, respectively, P both<0.05) and negatively correlated with gender, FT4(linear correlation coefficient were-0.709、-0.942, respectively, P both<0.05);7. In gout and hyperuricemia groups, TSH as the dependent variable and gender, age, BMI, SUA, Ccr, FT4, leptin as the independent variable for the linear multivariate regression analysis, the results show the women, age, BMI, SUA, FT4, HOMA-IR, leptin for regression equation of TSH,(β were-0.27,0.832,0.946,0.198,-0.942,0.895,0.650, respectively)(P both<0.05).Conclusion:1. The relevance ration of subhypothyroidism in gout/hyperuricemia was increased.2. Female, age, BMI, SUA, FT4, HOMA-IR, leptin were the independent risk factors.3. Insulin and leptin resistant played the media roles in gout/hyperuricemia and hypothyroidism. |
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