【摘要】 目的 探讨不同年龄段痛风发生代谢相关脂肪性肝病(MAFLD)的影响因素。方法 收集该院风湿免疫科2018年1月至2020年3月收治的痛风患者的临床资料，依据超声结果将患者分为MAFLD组(n=243)和非MAFLD组(n=159);并根据年龄分为≤45、>45～<65、≥65岁组，比较3组一般资料的差异。通过logistic回归分析青中年(年龄<65岁)及老年(年龄≥65岁)痛风发生MAFLD的风险因素。结果 痛风合并MAFLD患者占60.4%(243/402),其中出现肝功能异常者占64.6%(157/243);痛风合并MAFLD组体重指数(BMI)、血红蛋白(Hb)、血尿酸(UA)水平、高谷丙转氨酶(GPT)、高谷草转氨酶(GOT)、高谷氨酰转肽酶(GGT)、高甘油三酯(TG)血症与血UA/肌酐高于无MAFLD组，但发病年龄更小(P<0.05)。Logistic回归分析显示，高GPT、BMI、高TG血症为痛风人群发生MAFLD的风险因素(P<0.05);其中BMI是青中年痛风发生MAFLD的风险因素(P<0.05);高TG血症是老年痛风发生MAFLD的风险因素(P<0.05)。结论 不同年龄段痛风发生MAFLD的风险因素不同，对于青中年痛风患者，BMI的升高与MAFLD的关联更强；而对于老年痛风患者，高TG血症与MAFLD的发生更相关。更多还原

【Abstract】 Objective To investigate the influencing factors of metabolism associated fatty liver disease(MAFLD) in gout at different ages.Methods The clinical data of gout patients admitted to the Department of Rheumatology and Immunology of Zhejiang Hospital from January 2018 to March 2020 were collected, and the patients were divided into the MAFLD group(n=243) and the non-MAFLD group(n=159) according to ultrasonic results.According to age, they were divided into age ≤45 years; age >45-<65 years; age ≥65 years, and the differences of general data among the three groups were compared.Logistic regression was used to analyze young and middle age(age <65 years) and elderly(age≥65 years) risk factors for developing MAFLD with gout.Results The gout patients with MAFLD accounted for 60.4%(243/402).Abnormal liver function accounted of 64.6%(157/243) for the gout patients with MAFLD.The rates of abnormal BMI,hemoglobin(Hb),uric acid(UA),elevated glutamic pyruvic-transaminase(GPT),elevated glutamic-oxaloacetic transaminase(GOT),elevated glutamyltransferase(GGT),hypertriglyceridemia, Hb, UA/creatinine in the gout patients with MAFLD were higher than those in the non-MAFLD group, but the onset age was younger(P<0.05).Logistic regression showed that elevated GPT,BMI,hypertriglyceridemia were the risk factors for the occurrence of MAFLD in gout population(P<0.05).Among them, BMI were the risk factors for the occurrence of MAFLD in the young and middle-aged gout patients(P<0.05);For elderly gout, hypertriglyceridemia was the risk factor for the occurrence of MAFLD(P<0.05).Conclusion Elevated GPT,increased BMI and hypertriglyceridemia are risk factors for developing MAFLD in gout.Risk factors for fatty liver disease vary at different ages, for young and middle-aged gout, the increased BMI is more strongly associated with MAFLD,while for elderly gout, hypertriglyceridemia is more associated with the occurrence of MAFLD.It is very necessary to do a good job in screening MAFLD and monitoring liver function in gout.更多还原