Gout may be another indication for bariatric surgery in patients with obesity, investigators concluded.
In a retrospective study of 147 patients who underwent bariatric surgery for obesity (55 with hyperuricemia and 25 with gout) at Qujing Second People’s Hospital in Qujing City, China, Jine Lu, MD, and colleagues found that the mean weight reduction 1 year after surgery was approximately 30.7 kg. SUA decreased from approximately 7.04 mg/dL at baseline to 5.18 mg/dL at 1-7 days, flared up to 7.48 mg/dL at 1 month, then declined again to 6.45 mg/dL at 3 months, 5.87 mg/dL at 6 months, and 5.51 mg/dL at 12 months, Dr Lu’s team reported in Rheumatology. The investigators observed similar trends in the patients with hyperuricemia and gout.
At baseline, all 25 patients with gout had an SUA value above a therapeutic target of less than 6.05 mg/dL, but 10 patients achieved this target level at 12 months.
The mean reduction of SUA in all patients and gout patients was approximately 1.42 and 2.75 mg/dL, respectively, according to the investigators.
“Like with [type 2 diabetes mellitus],” the authors concluded, “gout may be considered as another indicator of bariatric surgery for patients with obesity.”
Although the mechanism by which bariatric surgery decreases SUA is largely unknown, data suggest that “the reduced SUA due to bariatric surgery may be attributable to multiple mechanisms of this therapy, including decreased intake of purine-rich food, less cell catabolism and increased renal excretion of uric acid,” the authors explained.
In a discussion of study limitations, the investigators pointed out that their analysis was retrospective and included only patients who underwent bariatric surgery at their hospital, some of whom had hyperuricemia or gout and others who did not. “Whether these participants are representative of the entire population with severe obesity eligible for bariatric surgery remains in question.”
Lu J, Bai Z, Chen Y, et al. Effects of bariatric surgery on serum uric acid in people with obesity with and without hyperuricaemia and gout: a retrospective analysis. Published online January 4, 2021. Rheumatology. doi:10.1093/rheumatology/keaa822