| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 88 === Objective: This is a fixed cohort study on asymptomatic hyperuricemic men aged ³ 30 in Kin-Hu, Kinmen to investigate the gout incidence and the risk factors for the development of gout.
Methods: 339 asymptomatic hyperuricemic men found in 1991-92 were followed-up during 1996 to 1999 with five surveys. Gout was clinically diagnosed by a senior rheumatologist based on history taking and performing a physical examination according to the clinical criteria of Wallace. Basic demographic and life style variables as well as biochemical data were collected in both baseline and follow-up periods.
Results: The 7-year cumulative incidence of gout was 20.9% (71/339) among asymptomatic hyperuricemic men in Kin-Hu. The risk factors of gout based on survival analysis were uric acid level, serum creatinine, alcohol consumption, diuretics use and hypertriglycemia. Uric acid level at baseline was the major predictor of gout. In addition, higher baseline serum creatinine was also predictive of gout especially for those with uric acid concentration between 7-8 mg/dl. After adjusting for uric acid level and serum creatinine concentration at baseline, it was found that alcohol consumption, use of diuretics and elevation of triglycerides during follow-up periods were time-dependent predictors for gout among asymptomatic hyperuricemic men.
Conclusion: Uric acid level and serum creatinine concentration are the key factors for primary prevention of gout. Other provocative factors such as alcohol consumption, diuretics use, and elevation of triglycerides also carry an increased risk of gout.
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