Chenxin Xu1,2, Jun Wen1,2, Huawu Yang1,2, Tongtong Zhang3, Yanjun Liu4,5, Tong Yan6,7, Yueting You8,9, Dafang Zhan1,2, Jiahui Yu1,2, Luo Fu1,2. 1. The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. 2. Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. 3. Medical Research Center, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. 163zttong@163.com. 4. The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. liuyanjun_001@163.com. 5. Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. liuyanjun_001@163.com. 6. The Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. ethanmed@yeah.net. 7. Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. ethanmed@yeah.net. 8. Department of Cardiovascular Disease, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, No. 82 Qinglong Road, Chengdu, 610031, Sichuan Province, China. 9. Cardiovascular Disease Research Institute of Chengdu, Chengdu, Sichuan, China.
Abstract
PURPOSE: In the short-term after bariatric surgery, the incidence of gout flare was increased. Patients with hyperuricemia are among the high-risk group of postoperative gout attacks. The drastic fluctuation of uric acid is a risk factor for gout flare. This study aimed to explore factors that influenced the magnitudes of serum uric acid (sUA) fluctuation post-surgery in patients with hyperuricemia. MATERIALS AND METHODS: One hundred and sixty-five patients with preoperative hyperuricemia undergoing bariatric surgery were reviewed. Pre- and postoperative parameters were collected at baseline and each follow-up point. Univariable and multiple linear regression analyses were performed to explore independent factors that influenced the magnitudes of sUA change. RESULTS: The sUA significantly declined from 489.4 ± 93.7 to 372.6 ± 101.4 μmmol/L in 1 day after surgery, then increased to 531.6 ± 175.5 μmmol/L at 1-month follow-up, and then dropped to 415.2 ± 105.6 and 396.5 ± 114.2 μmmol/L at 3-month and 6-month follow-up, respectively. Preoperative estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), magnesium (Mg), sex, and the change of zinc concentration during the first month are significantly related to magnitudes of sUA fluctuation in the short-term post-surgery period. Multiple linear regression analyses showed preoperative eGFR and HbA1c independently influenced the magnitudes of sUA change at 1 day after surgery; sex, the change of zinc concentration, and HbA1c at 1-month follow-up independently influenced the magnitudes of sUA change at 1-month follow-up. CONCLUSION: Preoperative eGFR, HbA1c, sex, and the change of zinc concentration postoperative are independent factors affecting the magnitude of the fluctuation. Large-scale studies are warranted to support these findings.
PURPOSE: In the short-term after bariatric surgery, the incidence of gout flare was increased. Patients with hyperuricemia are among the high-risk group of postoperative gout attacks. The drastic fluctuation of uric acid is a risk factor for gout flare. This study aimed to explore factors that influenced the magnitudes of serum uric acid (sUA) fluctuation post-surgery in patients with hyperuricemia. MATERIALS AND METHODS: One hundred and sixty-five patients with preoperative hyperuricemia undergoing bariatric surgery were reviewed. Pre- and postoperative parameters were collected at baseline and each follow-up point. Univariable and multiple linear regression analyses were performed to explore independent factors that influenced the magnitudes of sUA change. RESULTS: The sUA significantly declined from 489.4 ± 93.7 to 372.6 ± 101.4 μmmol/L in 1 day after surgery, then increased to 531.6 ± 175.5 μmmol/L at 1-month follow-up, and then dropped to 415.2 ± 105.6 and 396.5 ± 114.2 μmmol/L at 3-month and 6-month follow-up, respectively. Preoperative estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), magnesium (Mg), sex, and the change of zinc concentration during the first month are significantly related to magnitudes of sUA fluctuation in the short-term post-surgery period. Multiple linear regression analyses showed preoperative eGFR and HbA1c independently influenced the magnitudes of sUA change at 1 day after surgery; sex, the change of zinc concentration, and HbA1c at 1-month follow-up independently influenced the magnitudes of sUA change at 1-month follow-up. CONCLUSION: Preoperative eGFR, HbA1c, sex, and the change of zinc concentration postoperative are independent factors affecting the magnitude of the fluctuation. Large-scale studies are warranted to support these findings.
Authors: Jeffrey I Mechanick; Caroline Apovian; Stacy Brethauer; W Timothy Garvey; Aaron M Joffe; Julie Kim; Robert F Kushner; Richard Lindquist; Rachel Pessah-Pollack; Jennifer Seger; Richard D Urman; Stephanie Adams; John B Cleek; Riccardo Correa; M Kathleen Figaro; Karen Flanders; Jayleen Grams; Daniel L Hurley; Shanu Kothari; Michael V Seger; Christopher D Still Journal: Endocr Pract Date: 2019-11-04 Impact factor: 3.443