高半胱胺酸血症與痛風病患尿酸值無相關性

Hyperhomocysteinemia is not correlated with uric acid level in gout

目的：分析痛風病患半胱胺酸值及尿酸值之相關性。方法：收集193位痛風男性病患，分為四組：第一組50人為痛風尚未經降尿酸藥物治療之病患；第二組44人為使用降尿酸藥物後，尿酸值控制良好的痛風病患；第三組 49人為無症狀之高尿酸血症病患；第四組50人為健康男性為對照組。四組皆測其半胱胺酸及尿酸值，其中第一組於使用降尿酸藥物（allopurinol）二個月後再測一次半胱胺酸及尿酸值；而第二組於停藥二個月後再測量一次半胱胺酸及尿酸值。結果：血清中半胱胺酸值在第一組（14.1 ± 4.9 mol/L），第二組（12.7 ± 3.4 mol/L），第三組（9.8 ± 2.7 mol/L）以及第四組（9.2 ± 2.4 mol/L）（p<0.001）有顯著差異。在第一組中半胱胺酸值及尿酸值無論在allopurinol治療前與治療後均無相關且半胱胺酸值在allopurinol治療前（14.1 ± 4.9 mol/L）與治療後（13.0 ± 6.0mol/L）（p=0.31）並無顯著差異。在第二組中，半胱胺酸值及尿酸值無論在allopurinol停藥前與停藥後均無相關性，但半胱胺酸值在allopurinol停藥前（12.7 ± 3.4 mol/L）及停藥後（13.7 ± 3.8 mol/L）（p=0.022）有顯著差異；而在第一組與第二組中，尿酸變化值和半胱胺酸值變化值並無相關性。結論：在痛風病患，血中半胱胺酸值和尿酸值並無相關性。

Objective: To analyze the association of total homocysteine (tHcy) levels with uric acid (UA) levels in gouty patients. Methods: We enrolled 193 male participants: 50 gouty patients without initiation of hypouricemic agent, group I (Gr I); 44 gouty patients after medical control of serum UA level, group II (Gr II); 49 communitybased asymptomatic hyperuricemic patients, group III (Gr III); and 50 community-based normouricemic healthy subjects as control, group IV (Gr IV). Levels of tHcy and UA were measured for all subjects and repeated for Gr I patients after treatment with allopurinol and group II patients following withdrawal of allopurinol treatment for 2 months. Results: The results revealed that Gr I (14.1 ± 4.9 μmol/L) and Gr II (12.7 ± 3.4 μmol/L) had significantly higher serum tHcy levels than Gr III (9.8 ± 2.7 μmol/L) (p<0.001 and p=0.001 respectively) and Gr IV (9.2 ± 2.4 μmol/L) (p<0.001 and p<0.001 respectively). There was no correlation between tHcy and UA levels for Gr I (p=0.111, r=0.228). No significant difference was noted for tHcy levels in Gr I between preallopurinol treatment (14.1 ± 4.9 μmol/L) and its post-treatment analogue (13.0 ± 6.0 μmol/L) (p=0.31). The tHcy levels for Gr II were significantly different between pre-allopurinol administration (12.7 ± 3.4 μmol/L) and its post-withdrawal analogue (13.7 ± 3.8 μmol/L) (p=0.022). The changes of UA levels after administration and withdrawal of allopurinol in Gr I and Gr II respectively, do not correlate with the changes of tHcy. Conclusion: Elevated tHcy levels in gouty patients are not correlated with UA levels.