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Abstract：
BACKGROUND: The purpose of this study was to investigate the relationships between generalized, abdominal, and visceral fat obesity and the prevalence of gout in patients with type 2 diabetes mellitus (T2DM).
METHODS: Data were obtained from the electronic medical databases of the National Metabolic Management Center (MMC) of Yuhuan Second People\'s Hospital and Taizhou Central Hospital (Taizhou University Hospital) between September 2017 and June 2023. Four obesity indicators were analyzed: waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and visceral fat area (VFA). The relationships between these parameters and gout prevalence were analyzed using multivariate logistic regression and restricted cubic spline (RCS) analyses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of the four parameters for gout.
RESULTS: This cross-sectional study enrolled 10,535 participants (600 cases and 9,935 controls). Obesity was more common in patients with gout, and the obesity indicators were markedly higher in this group. After adjustment for confounders, obesity, as defined by BMI, WC, WHR, and VFA, was found to be associated with greater gout prevalence, with odds ratios (OR) of 1.775, 1.691, 1.858, and 1.578, respectively (P < 0.001). The gout odds ratios increased markedly in relation to the obesity indicator quartiles (P-value for trend < 0.001), and the obesity indicators were positively correlated with gout prevalence, as shown using RCS. The area under the ROC curve values for BMI, WC, WHR, and VFA were 0.629, 0.651, 0.634, and 0.633, respectively.
CONCLUSIONS: Obesity-whether general, abdominal, or visceral fat obesity-was positively linked with elevated gout risk. But uncovering the causality behind the relationship requires further prospective study. Obesity indicators (BMI, WC, WHR, and VFA) may have potential value for diagnosing gout in clinical practice.
METHODS: Data were obtained from the electronic medical databases of the National Metabolic Management Center (MMC) of Yuhuan Second People\'s Hospital and Taizhou Central Hospital (Taizhou University Hospital) between September 2017 and June 2023. Four obesity indicators were analyzed: waist circumference (WC), waist-to-hip ratio (WHR), body mass index (BMI), and visceral fat area (VFA). The relationships between these parameters and gout prevalence were analyzed using multivariate logistic regression and restricted cubic spline (RCS) analyses. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of the four parameters for gout.
RESULTS: This cross-sectional study enrolled 10,535 participants (600 cases and 9,935 controls). Obesity was more common in patients with gout, and the obesity indicators were markedly higher in this group. After adjustment for confounders, obesity, as defined by BMI, WC, WHR, and VFA, was found to be associated with greater gout prevalence, with odds ratios (OR) of 1.775, 1.691, 1.858, and 1.578, respectively (P < 0.001). The gout odds ratios increased markedly in relation to the obesity indicator quartiles (P-value for trend < 0.001), and the obesity indicators were positively correlated with gout prevalence, as shown using RCS. The area under the ROC curve values for BMI, WC, WHR, and VFA were 0.629, 0.651, 0.634, and 0.633, respectively.
CONCLUSIONS: Obesity-whether general, abdominal, or visceral fat obesity-was positively linked with elevated gout risk. But uncovering the causality behind the relationship requires further prospective study. Obesity indicators (BMI, WC, WHR, and VFA) may have potential value for diagnosing gout in clinical practice.
摘要：
背景：这项研究的目的是调查广义，腹部，2型糖尿病（T2DM）患者的内脏脂肪肥胖和痛风患病率。
方法：数据来源于2017年9月至2023年6月玉环第二人民医院国家代谢管理中心（MMC）和台州市中心医院（台州大学附属医院）的电子医学数据库。分析了四个肥胖指标：腰围（WC），腰臀比（WHR），体重指数（BMI），内脏脂肪面积（VFA）。使用多变量逻辑回归和限制性三次样条（RCS）分析这些参数与痛风患病率之间的关系。使用受试者工作特征（ROC）曲线来评估四个参数对痛风的诊断功效。
结果：这项横断面研究纳入了10,535名参与者（600例和9,935名对照）。肥胖在痛风患者中更为常见，肥胖指标明显高于该组。在对混杂因素进行调整后，肥胖，根据BMI的定义，WC,WHR,VFA,被发现与更高的痛风患病率有关，比值比（OR）分别为1.775、1.691、1.858和1.578（P<0.001）。与肥胖指标四分位数相关的痛风比值比显着增加（趋势P值<0.001），肥胖指标与痛风患病率呈正相关,如使用RCS所示。BMI的ROC曲线下面积值，WC,WHR,VFA分别为0.629、0.651、0.634和0.633。
结论：肥胖-无论是一般性的，腹部，或内脏脂肪肥胖-与痛风风险升高呈正相关。但要发现这种关系背后的因果关系，还需要进一步的前瞻性研究。肥胖指标(BMI，WC,WHR,和VFA）在临床实践中可能对诊断痛风具有潜在价值。
方法：数据来源于2017年9月至2023年6月玉环第二人民医院国家代谢管理中心（MMC）和台州市中心医院（台州大学附属医院）的电子医学数据库。分析了四个肥胖指标：腰围（WC），腰臀比（WHR），体重指数（BMI），内脏脂肪面积（VFA）。使用多变量逻辑回归和限制性三次样条（RCS）分析这些参数与痛风患病率之间的关系。使用受试者工作特征（ROC）曲线来评估四个参数对痛风的诊断功效。
结果：这项横断面研究纳入了10,535名参与者（600例和9,935名对照）。肥胖在痛风患者中更为常见，肥胖指标明显高于该组。在对混杂因素进行调整后，肥胖，根据BMI的定义，WC,WHR,VFA,被发现与更高的痛风患病率有关，比值比（OR）分别为1.775、1.691、1.858和1.578（P<0.001）。与肥胖指标四分位数相关的痛风比值比显着增加（趋势P值<0.001），肥胖指标与痛风患病率呈正相关,如使用RCS所示。BMI的ROC曲线下面积值，WC,WHR,VFA分别为0.629、0.651、0.634和0.633。
结论：肥胖-无论是一般性的，腹部，或内脏脂肪肥胖-与痛风风险升高呈正相关。但要发现这种关系背后的因果关系，还需要进一步的前瞻性研究。肥胖指标(BMI，WC,WHR,和VFA）在临床实践中可能对诊断痛风具有潜在价值。
