Risk Factors Of Acute Gouty Attack In The Short Term After Bariatric Surgery

Objective: To investigate the clinical characteristics and risk factors of acute gout attack in patients undergoing bariatric surgery.Methods: A retrospective analysis was conducted to collect the preoperative and postoperative clinical characteristics and data of patients with gout who underwent bariatric surgery in the Fourth Affiliated Hospital of China Medical University from January to October 2022.Patients were divided into attack group and non-attack group according to whether they had acute gout attack at 1 month after operation.Independent sample t test,chi-square test and Mann-Whitney test were used to compare the differences between the two groups to find out the risk factors for postsurgical gout attack.Multivariate Logistic analysis was used to find out the independent risk factors for postoperative gout attack.Paired t test was used to compare the differences of preoperative and postoperative clinical characteristics in the attack group.Results: A total of 449 patients with metabolic syndrome who underwent surgical treatment in our hospital from January to October 2022 were enrolled in this study.Among them,49 patients(11%)who has been received our follow-up,had gouty attack or diagnosed as acute gout attack for the first time by specialist consultation within 1month after surgery.There were 36 patients(73.5%)in the attack group and 13 patients(26.5%)in the non-attack group.In the data we collected,C-peptide 60min(p=0.018),history of gout before surgery(p=0.019),number of attacks within 1 year before surgery(p=0.019),absolute value of serum uric acid change 1 month after surgery(p=0.015)and preoperative medication(p=0.008)were significantly different between the two groups.The difference was statistically significant(p < 0.05).Multivariate Logistic regression analysis showed that the number of gout attacks within one year before surgery and the absolute value of serum uric acid change one month after surgery were independent risk factors for postoperative gout recurrence.The duration of peak pain after surgery was longer than that before surgery.Conclusion: The incidence of acute gout attack in patients after bariatric surgery is very high,and the symptoms are more severe than before.The number of gout attacks within one year before surgery and the change of serum uric acid one month after surgery are strong predictors of acute gout attacks after bariatric surgery.