Wei Liu , Peng Dong , Chunyan Li , Wen Guo , Kaiping Zhao , Siliang Man , Liang Zhang , Husheng Wu , Hui Song
{"title":"痛风发作后持续性关节疼痛的临床意义","authors":"Wei Liu , Peng Dong , Chunyan Li , Wen Guo , Kaiping Zhao , Siliang Man , Liang Zhang , Husheng Wu , Hui Song","doi":"10.1016/j.reuma.2024.03.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><p>A subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis.</p></div><div><h3>Methods</h3><p>We analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares.</p></div><div><h3>Results</h3><p>A total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (<em>P</em> <!--><<!--> <!-->0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% <em>vs.</em> 21.1%) and bone erosion (18.6% <em>vs.</em> 8.6%) (<em>P</em> <!--><<!--> <!-->0.05). Higher UA and lower TBil were found in patients with persistent joint pain (<em>P</em> <!--><<!--> <!-->0.001). Hypertension (54.9% <em>vs.</em> 38.7%) and metabolic syndrome (58.8% <em>vs.</em> 46.4%) were both more frequent in patients with persistent joint pain (<em>P</em> <!--><<!--> <!-->0.05). TBil was negatively correlated with the incidence of persistent joint pain (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.190), UA values (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.125), and metabolic syndrome scores (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.192). A correlation curve was fitted using LOESS (locally weighted region).</p></div><div><h3>Conclusion</h3><p>Persistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.</p></div>","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical implications of persistent joint pain after gout flare\",\"authors\":\"Wei Liu , Peng Dong , Chunyan Li , Wen Guo , Kaiping Zhao , Siliang Man , Liang Zhang , Husheng Wu , Hui Song\",\"doi\":\"10.1016/j.reuma.2024.03.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>A subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis.</p></div><div><h3>Methods</h3><p>We analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares.</p></div><div><h3>Results</h3><p>A total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (<em>P</em> <!--><<!--> <!-->0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% <em>vs.</em> 21.1%) and bone erosion (18.6% <em>vs.</em> 8.6%) (<em>P</em> <!--><<!--> <!-->0.05). Higher UA and lower TBil were found in patients with persistent joint pain (<em>P</em> <!--><<!--> <!-->0.001). Hypertension (54.9% <em>vs.</em> 38.7%) and metabolic syndrome (58.8% <em>vs.</em> 46.4%) were both more frequent in patients with persistent joint pain (<em>P</em> <!--><<!--> <!-->0.05). TBil was negatively correlated with the incidence of persistent joint pain (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.190), UA values (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.125), and metabolic syndrome scores (<em>P</em> <!--><<!--> <!-->0.001, <em>r</em> <!-->=<!--> <!-->−0.192). A correlation curve was fitted using LOESS (locally weighted region).</p></div><div><h3>Conclusion</h3><p>Persistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.</p></div>\",\"PeriodicalId\":1,\"journal\":{\"name\":\"Accounts of Chemical Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":16.4000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Accounts of Chemical Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1699258X24000287\",\"RegionNum\":1,\"RegionCategory\":\"化学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MULTIDISCIPLINARY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1699258X24000287","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}
Clinical implications of persistent joint pain after gout flare
Objectives
A subset of gout patients developed persistent joint pain after flares. Analysis of this clinical phenomenon may shed further light on the factors related to worsening gout and even provide clues to its pathogenesis.
Methods
We analyzed the clinical, laboratory, and ultrasound data of gout patients to explore the associations of these data with persistent joint pain after gout flares.
Results
A total of 1029 gout patients were included: 182 (17.7%) patients with persistent joint pain and 847 (82.3%) patients with nonpersistent joint pain. Patients with persistent joint pain had more total involved joints, more gout flares in the past year, and more joints with simultaneous gout flares (P < 0.01). Among the ultrasound-detected lesions, patients with persistent joint pain had a higher incidence of tophus (36.4% vs. 21.1%) and bone erosion (18.6% vs. 8.6%) (P < 0.05). Higher UA and lower TBil were found in patients with persistent joint pain (P < 0.001). Hypertension (54.9% vs. 38.7%) and metabolic syndrome (58.8% vs. 46.4%) were both more frequent in patients with persistent joint pain (P < 0.05). TBil was negatively correlated with the incidence of persistent joint pain (P < 0.001, r = −0.190), UA values (P < 0.001, r = −0.125), and metabolic syndrome scores (P < 0.001, r = −0.192). A correlation curve was fitted using LOESS (locally weighted region).
Conclusion
Persistent joint pain after gout flares is a marker of increased disease burden in gout. The significance of the level of total bilirubin for the exacerbation of gout deserves further study.
期刊介绍:
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.