To clarify the relationship between serum urate (SU) decrease and visceral fat area (VFA) reduction in patients with gout.

We retrospectively analyzed 237 male gout patients who had two sets of body composition and metabolic measurements within 6 months. Subjects included had all been treated with urate-lowering therapy (ULT) (febuxostat 20–80 mg/day or benzbromarone 25–50 mg/day, validated by the medical record). All patients were from the specialty gout clinic of The Affiliated Hospital of Qingdao University. The multiple linear regression model evaluated the relationship between change in SU [ΔSU, (baseline SU) – (final visit SU)] and change in VFA [ΔVFA, (baseline VFA) – (final visit VFA)].

ULT resulted in a mean (standard deviation) decrease in SU level (464.22 ± 110.21 μmol/L at baseline, 360.93 ± 91.66 μmol/L at the final visit, p <0.001) accompanied by a decrease in median (interquartile range) VFA [97.30 (81.15–118.55) at baseline, 90.90 (75.85–110.05) at the final visit, p < 0.001]. By multiple regression model, ΔSU was identified to be a significant determinant variable of decrease in VFA (beta, 0.302; p = 0.001).

The decrease in SU level is positively associated with reduced VFA. This finding provides a rationale for clinical trials to affirm whether ULT promotes loss of visceral fat in patients with gout.

阐明痛风患者血清尿酸（SU）降低与内脏脂肪面积（VFA）降低​​的关系。

我们回顾性分析了 237 名男性痛风患者，他们在 6 个月内进行了两组身体成分和代谢测量。纳入的受试者均接受过降尿酸治疗 (ULT)（非布司他 20-80 毫克/天或苯溴马隆 25-50 毫克/天，经病历验证）。所有患者均来自青岛大学附属医院痛风专科门诊。多元线性回归模型评估了 SU [ΔSU, (baseline SU) – (final visit SU)] 和 VFA [ΔVFA, (baseline VFA) – (final visit VFA)] 的变化之间的关系。

ULT 导致 SU 水平平均（标准偏差）降低（基线时为 464.22 ± 110.21 μmol/L，最后一次访问时为 360.93 ± 91.66 μmol/L，p <0.001）伴随着中位数（四分位距）VFA 下降 [基线时为 97.30 (81.15–118.55)，最后一次访问时为 90.90 (75.85–110.05)，p < 0.001]。通过多元回归模型，ΔSU 被确定为 VFA 降低的重要决定变量（β，0.302；p= 0.001)。

SU 水平的降低与 VFA 的降低呈正相关。这一发现为临床试验提供了依据，以确认 ULT 是否促进痛风患者内脏脂肪的减少。