Chinese General Practice ›› 2023, Vol. 26 ›› Issue (12): 1479-1484.DOI: 10.12114/j.issn.1007-9572.2022.0710

Special Issue: 消化系统疾病最新文章合集

• Original Research • Previous Articles     Next Articles

Association between Serum Potassium and Metabolic-associated Fatty Liver Disease in Patients with Primary Gout

  

  1. 1Department of Infection Management, Chu Hsien-I Memorial Hospital, Tianjin Medical University, Tianjin 300134, China
    2Tianjin Institute of Endocrinology, Tianjin 300134, China
    3NHC Key Laboratory of Hormones and Development, Tianjin 300134, China
    4Tianjin Key Laboratory of Metabolic Diseases, Tianjin 300134, China
    5Department of Gout, Chu Hsien-I Memorial Hospital, Tianjin Medical University, Tianjin 300134, China
  • Received:2022-08-25 Revised:2022-11-19 Published:2023-04-20 Online:2022-12-29
  • Contact: NIE Xiuling

痛风患者血钾水平与代谢相关脂肪性肝病的相关性研究

  

  1. 1300134 天津市,天津医科大学朱宪彝纪念医院感染管理科
    2300134 天津市内分泌研究所
    3300134 天津市,国家卫健委激素与发育重点实验室
    4300134 天津市代谢性疾病重点实验室
    5300134 天津市,天津医科大学朱宪彝纪念医院痛风科
  • 通讯作者: 聂秀玲
  • 作者简介:
    作者贡献:聂秀玲提出概念及可行性分析;王俊伟行统计学处理,结果的分析与解释,文章的构思与设计并撰写论文;林令君负责文章的质量控制及审校;宋林凌、成晓翠进行数据收集、数据整理及录入;王俊伟、聂秀玲对文章整体负责。
  • 基金资助:
    天津市医学重点学科(专科)建设项目(TJYXZDXK-032A); 天津医科大学朱宪彝纪念医院科研基金(2019ZDKF13)

Abstract:

Background

Metabolic-associated fatty liver disease (MAFLD) is a group of liver diseases related to metabolic stresses. Studies have shown that serum potassium is closely related to MAFLD. However, their relationship in gout patients remains unclear.

Objective

To investigate the relationship between serum potassium and MAFLD in gout patients, to provide a theoretical basis for the management of serum potassium in gout patients.

Methods

A total of 347 primary gout patients were recruited from Chu Hsien-I Memorial Hospital, Tianjin Medical University from April 2014 to March 2017. They were divided into simple gout group (n=96) , mild fatty liver group (n=136) and moderate-to-severe fatty liver group (n=115) according to the severity of fatty liver to compare baseline data, serum biochemical indices, overweight/obesity and insulin resistance indices. Spearman rank correlation was used to study the relationship between serum potassium level and the severity of fatty liver. Multivariate Logistic regression analysis was used to identify influencing factors of MAFLD in gout.

Results

Two hundred and fifty-one (72.3%) of the 347 gout patients had MAFLD. Spearman rank correlation analysis demonstrated that serum potassium level was negatively correlated with the severity of fatty liver, fasting blood glucose (FBG) , triglyceride (TG) , body mass index (BMI) , waist-to-hip ratio (WHR) and homeostasis model assessment of insulin resistance (HOMA-IR) (rs=-0.172, -0.118, -0.182, -0.222, -0.174, -0.197, P<0.05) . The chi-square test for linear trend showed that the severity of fatty liver declined with the increase of serum potassium level (χ2 =15.784, P=0.015) . Multivariate Logistic regression analysis showed that advanced age〔OR=0.97, 95%CI (0.95, 0.999) 〕 and high serum potassium〔OR=0.53, 95%CI (0.29, 0.97) 〕 were associated with reduced risk of developing MAFLD in overweight/obese gout patients (P<0.05) , while high TG〔OR=1.16, 95%CI (1.01, 1.34) 〕 and high WHR〔OR=1.09, 95%CI (1.04, 1.13) 〕 were associated with increased risk of developing MAFLD (P<0.05) . High FBG〔OR=1.92, 95%CI (1.12, 3.31) 〕 was associated with increased risk of developing MAFLD in gout patients with normal BMI (P<0.05) .

Conclusion

Maintaining higher serum potassium within the normal range may prevent the development of MAFLD in overweight/obese gout patients.

Key words: Gout, Fatty liver, Metabolic dysfunction-associated fatty liver disease, Serum potassium, Insulin resistant, Central obesity, Root cause analysis

摘要:

背景

代谢相关脂肪性肝病(MAFLD)是一组代谢应激相关的肝脏疾病,有研究表明血钾水平与MAFLD密切相关,但针对痛风患者二者的关系尚不清楚。

目的

探讨痛风患者血钾水平与MAFLD的关系,旨在为痛风患者血钾水平的管理提供理论依据。

方法

选取2014年4月至2017年3月于天津医科大学朱宪彝纪念医院住院的原发性痛风患者347例作为研究对象。根据脂肪肝严重程度分为单纯痛风组(n=96)、轻度脂肪肝组(n=136)及中重度脂肪肝组(n=115)。比较不同脂肪肝严重程度组一般资料、血清生化指标及超重/肥胖、胰岛素抵抗指标,采用Spearman秩相关分析探讨血钾水平与脂肪肝严重程度的关系,采用多因素Logistic回归分析探讨痛风患者MAFLD发生发展的影响因素。

结果

痛风患者MAFLD患病率为72.3%(251/347)。Spearman秩相关分析结果显示血钾水平与脂肪肝严重程度、空腹血糖(FBG)、三酰甘油(TG)、体质指数(BMI)、腰臀比(WHR)及胰岛素抵抗指数(HOMA-IR)呈负相关(rs=-0.172、-0.118、-0.182、-0.222、-0.174、-0.197,P<0.05)。趋势χ2检验结果显示脂肪肝严重程度随着血钾水平的增加呈下降趋势(χ2趋势=15.784,P=0.015)。多因素Logistic回归分析结果显示,高龄〔OR=0.97,95%CI(0.95,0.999)〕、高钾〔OR=0.53,95%CI(0.29,0.97)〕是超重/肥胖痛风患者MAFLD发生发展的保护因素(P<0.05),高TG〔OR=1.16,95%CI(1.01,1.34)〕、高WHR〔OR=1.09,95%CI(1.04,1.13)〕是超重/肥胖痛风患者MAFLD发生发展的危险因素(P<0.05);高FBG〔OR=1.92,95%CI(1.12,3.31)〕是体质量正常痛风患者MAFLD发生发展的危险因素(P<0.05)。

结论

对于超重/肥胖的痛风患者,维持血钾在参考范围偏高水平可能有助于预防MAFLD的发生、发展。

关键词: 痛风, 脂肪肝, 代谢相关脂肪性肝病, 血钾, 胰岛素抵抗, 中心性肥胖, 影响因素分析