基因與運動與台灣民眾痛風得病風險的關聯性

Relationship of genes and exercise with risk of gout in a Taiwanese population

目標：痛風是尿酸累積所導致的關節炎，影響痛風發生的因素可分為環境及個體差異，環境包含生活習慣、運動、飲食等，個體差異包含共病症的有無以及基因差異，以上因素皆可能影響痛風得病風險。先前研究中基因的影響及基因和環境之間的關聯仍未完全解析。本研究目的為探討痛風、基因風險與運動之關聯。方法：本研究為橫斷性研究，運用台灣人體生物資料庫，納入11,865位基因資料與問卷資料兩者皆有資料之受試者。爾後進行運動問卷資料與受試者自述是否有經醫生診斷之痛風作為判定是否罹患痛風之狀況。依據上述研究流程，最後本研究納入1,727位受試者（其中痛風者為353人，非痛風者為1,374人）進行相關分析研究。另外以基因數據篩選遺傳變異位點後估計基因風險分數，並由問卷中的運動類型與頻率等資訊估計運動消耗熱量進行分組分析。結果：本研究結果顯示運動消耗熱量與痛風發生有關聯性。相較於運動量低的民眾，進行適當運動量的民眾可觀察到較低的痛風得病風險，但如果在過度運動的情況下，痛風得病風險則可能有提高的情形（p = 0.031）。上述現象在低基因風險組仍發現相同趨勢（p = 0.034）。結論：運動與基因風險可能與台灣民眾痛風的發生風險有關，未來將可進一步進行前瞻性長期追蹤與預防性研究。

Objectives: Gout is a type of arthritis caused by abnormal purine metabolism and uric acid accumulation. Various environmental factors (e.g., living habits, exercise, diet, and individual differences) and individual factors (the presence or absence of comorbidities and genetic differences) are associated with the occurrence and severity of gout. Epidemiological studies have extensively examined the influence of exercise, diet, and comorbidities; however, the influence of genes on gout and the relationship between genes and the environment require further verification. Therefore, this study aimed to evaluate the association of gout with genetic variation and exercise in a Taiwanese population. Methods: We collected genetic and questionnaire data from Taiwan Biobank, conducted a data analysis after screening for genetic mutation sites, and obtained genetic risk scores. Results: Moderate exercise (not too high or low) was associated with decreased gout incidence. A genetic risk stratification analysis yielded similar results only among individuals with low and not high genetic risk. Conclusions: Our findings suggest that exercise has a greater effect on gout in individuals with low genetic risk than in those with high genetic risk.