Risk factors for osteoporosis in patients with primary gout and development of a prediction model

doi:10.3969/j.issn.1004-583X.2026.04.006

Abstract

Abstract:

Objective To analyze the clinical characteristics and independent risk factors of osteoporosis in male patients with primary gout, and to develop an osteoporosis risk prediction tool for this population to support early clinical screening. Methods A retrospective cohort design was used, involving 348 male patients with primary gout at Xichong County People's Hospital and Affiliated Hospital of North Sichuan Medical College. Clinical data, laboratory indices, and bone mineral density results were collected for all participants. Variables with P<0.05 in the univariate analysis were entered into a multivariate logistic regression model to establish a prediction formula. Receiver operating characteristic curve analysis was used to evaluate the discriminative ability of the model. Bootstrap resampling was performed for internal validation, and the Hosmer-Lemeshow test and calibration curve were used to assess calibration. Results Among the 348 male patients, 31 cases (8.9%) had osteoporosis. Univariate analysis showed that age, disease duration, tophi, diabetes, high-sensitivity C-reactive protein, and serum creatinine were significantly associated with osteoporosis (P<0.05). Multivariate logistic regression identified age, tophi, and serum creatinine as independent risk factors. The prediction model was as follows: Logit(P)=-6.425+0.055×age (years)+1.038×tophi (yes=1, no=0)+0.005×serum creatinine (μmol/L). The initial area under the curve (AUC) of the model was 0.796, and the Bootstrap-corrected AUC was 0.781. The Hosmer-Lemeshow test yielded P=0.422, and the calibration curve indicated good model fit. Conclusion Advanced age, presence of tophi, and elevated serum creatinine are independent risk factors for osteoporosis in male patients with primary gout. The constructed risk prediction model demonstrates good discriminative ability and calibration, and may serve as an effective tool for screening high-risk osteoporosis in middle-aged and elderly male patients with gout.

Key words: gout, osteoporosis, risk factors, prediction model

CLC Number:

R589.7
R681

Wang Peng, Yu Ling, Xu Lichuan, Pang Min, Li Guo, Zheng Hongkun, Zhang Quanbo, Qing Yufeng. Risk factors for osteoporosis in patients with primary gout and development of a prediction model[J]. Clinical Focus, 2026, 41(4): 323-327.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.04.006

https://www.lchc.cn/EN/Y2026/V41/I4/323

Figures/Tables 3

Tab.1 Baseline characteristics of patients with primary gout in the osteoporosis and non-osteoporosis groups

变量	总体( $n$ =348)	骨质疏松组( $n$ =31)	非骨质疏松组( $n$ =317)	统计值	$P$ 值
人口学特征
年龄(岁)	57.3±15.2	68.9±12.1	56.1±15.0	$t$ =4.98	<0.001
体重指数(kg/m²)	25.3±4.3	24.7±4.2	25.4±4.3	$t$ =0.85	0.396
痛风相关特征
病程(年)	7.0(3.0, 11.0)	10.0(5.0, 18.0)	7.0(2.5, 10.0)	$Z$ =2.31	0.021
痛风石[例(%)]	70(20.1)	13(41.9)	57(18.0)	χ²=10.24	0.001
生活习惯[例(%)]
吸烟史	149(42.8)	11(35.5)	138(43.5)	χ²=0.74	0.390
饮酒史	186(53.4)	18(58.1)	168(53.0)	χ²=0.30	0.584
合并症[例(%)]
高血压	122(35.1)	13(41.9)	109(34.4)	χ²=0.73	0.393
糖尿病	33(9.5)	6(19.4)	27(8.5)	χ²=3.98	0.046
肾结石	21(6.0)	3(9.7)	18(5.7)	χ²=0.82	0.365
实验室指标
hs-CRP(mg/L)	53.0(23.0, 69.0)	81.0(46.0, 126.0)	51.0(21.0, 64.0)	$Z$ =2.92	0.003
白细胞(×10⁹/L)	8.4±3.2	9.1±3.8	8.3±3.1	$t$ =1.42	0.156
丙氨酸氨基转移酶(U/L)	28.0(18.0, 42.0)	26.0(17.0, 39.0)	28.0(18.0, 43.0)	$Z$ =0.55	0.582
天门冬氨酸氨基转移酶(U/L)	24.0(18.0, 33.0)	25.0(19.0, 35.0)	24.0(18.0, 32.0)	$Z$ =0.68	0.497
白蛋白(g/L)	39.8±5.2	38.6±5.8	39.9±5.1	$t$ =1.31	0.190
血尿酸(μmol/L)	488.5±143.0	516.0±154.0	485.0±141.0	$t$ =1.06	0.290
血肌酐(μmol/L)	98.2(71.0, 114.5)	136.0(96.0, 187.0)	95.0(69.0, 109.0)	$Z$ =3.18	0.001
甘油三酯(mmol/L)	1.45(0.96, 2.10)	1.60(1.05, 2.45)	1.44(0.95, 2.08)	$Z$ =1.15	0.250
总胆固醇(mmol/L)	4.41±1.18	4.28±1.05	4.42±1.19	$t$ =0.63	0.528
低密度脂蛋白胆固醇(mmol/L)	2.65±0.98	2.58±0.87	2.66±0.99	$t$ =0.44	0.664
血糖(mmol/L)	5.6(5.0, 6.5)	6.2(5.3, 7.8)	5.5(5.0, 6.4)	$Z$ =1.98	0.048

Tab.1 Baseline characteristics of patients with primary gout in the osteoporosis and non-osteoporosis groups

变量	总体( $n$ =348)	骨质疏松组( $n$ =31)	非骨质疏松组( $n$ =317)	统计值	$P$ 值
人口学特征
年龄(岁)	57.3±15.2	68.9±12.1	56.1±15.0	$t$ =4.98	<0.001
体重指数(kg/m²)	25.3±4.3	24.7±4.2	25.4±4.3	$t$ =0.85	0.396
痛风相关特征
病程(年)	7.0(3.0, 11.0)	10.0(5.0, 18.0)	7.0(2.5, 10.0)	$Z$ =2.31	0.021
痛风石[例(%)]	70(20.1)	13(41.9)	57(18.0)	χ²=10.24	0.001
生活习惯[例(%)]
吸烟史	149(42.8)	11(35.5)	138(43.5)	χ²=0.74	0.390
饮酒史	186(53.4)	18(58.1)	168(53.0)	χ²=0.30	0.584
合并症[例(%)]
高血压	122(35.1)	13(41.9)	109(34.4)	χ²=0.73	0.393
糖尿病	33(9.5)	6(19.4)	27(8.5)	χ²=3.98	0.046
肾结石	21(6.0)	3(9.7)	18(5.7)	χ²=0.82	0.365
实验室指标
hs-CRP(mg/L)	53.0(23.0, 69.0)	81.0(46.0, 126.0)	51.0(21.0, 64.0)	$Z$ =2.92	0.003
白细胞(×10⁹/L)	8.4±3.2	9.1±3.8	8.3±3.1	$t$ =1.42	0.156
丙氨酸氨基转移酶(U/L)	28.0(18.0, 42.0)	26.0(17.0, 39.0)	28.0(18.0, 43.0)	$Z$ =0.55	0.582
天门冬氨酸氨基转移酶(U/L)	24.0(18.0, 33.0)	25.0(19.0, 35.0)	24.0(18.0, 32.0)	$Z$ =0.68	0.497
白蛋白(g/L)	39.8±5.2	38.6±5.8	39.9±5.1	$t$ =1.31	0.190
血尿酸(μmol/L)	488.5±143.0	516.0±154.0	485.0±141.0	$t$ =1.06	0.290
血肌酐(μmol/L)	98.2(71.0, 114.5)	136.0(96.0, 187.0)	95.0(69.0, 109.0)	$Z$ =3.18	0.001
甘油三酯(mmol/L)	1.45(0.96, 2.10)	1.60(1.05, 2.45)	1.44(0.95, 2.08)	$Z$ =1.15	0.250
总胆固醇(mmol/L)	4.41±1.18	4.28±1.05	4.42±1.19	$t$ =0.63	0.528
低密度脂蛋白胆固醇(mmol/L)	2.65±0.98	2.58±0.87	2.66±0.99	$t$ =0.44	0.664
血糖(mmol/L)	5.6(5.0, 6.5)	6.2(5.3, 7.8)	5.5(5.0, 6.4)	$Z$ =1.98	0.048

Tab.2 Univariate logistic regression analysis of factors influencing osteoporosis

变量	回归系数	标准误	Wald χ²值	$O R$ 值	95% $C I$	$P$ 值
年龄(岁)	0.056	0.014	16.00	1.058	1.031-1.086	<0.01
病程(年)	0.048	0.018	7.11	1.049	1.013-1.086	0.008
痛风石(有vs无)	1.165	0.398	8.57	3.205	1.472-6.979	0.003
糖尿病(有vs无)	0.972	0.435	4.99	2.643	1.127-6.202	0.026
血肌酐(μmol/L)	0.006	0.002	9.00	1.006	1.002-1.010	0.003
hs-CRP(mg/L)	0.007	0.003	5.44	1.007	1.001-1.013	0.020
体重指数(kg/m²)	-0.024	0.036	0.44	0.976	0.908-1.049	0.507
吸烟史(有vs无)	-0.090	0.378	0.06	0.914	0.436-1.917	0.812
饮酒史(有vs无)	0.150	0.373	0.16	1.162	0.558-2.421	0.689
高血压(有vs无)	0.192	0.371	0.27	1.212	0.582-2.524	0.608
肾结石(有vs无)	0.520	0.538	0.93	1.682	0.582-4.860	0.334
血尿酸(μmol/L)	0.001	0.001	1.14	1.001	0.999-1.003	0.285
血糖(mmol/L)	0.062	0.041	2.29	1.064	0.983-1.152	0.130

Tab.2 Univariate logistic regression analysis of factors influencing osteoporosis

变量	回归系数	标准误	Wald χ²值	$O R$ 值	95% $C I$	$P$ 值
年龄(岁)	0.056	0.014	16.00	1.058	1.031-1.086	<0.01
病程(年)	0.048	0.018	7.11	1.049	1.013-1.086	0.008
痛风石(有vs无)	1.165	0.398	8.57	3.205	1.472-6.979	0.003
糖尿病(有vs无)	0.972	0.435	4.99	2.643	1.127-6.202	0.026
血肌酐(μmol/L)	0.006	0.002	9.00	1.006	1.002-1.010	0.003
hs-CRP(mg/L)	0.007	0.003	5.44	1.007	1.001-1.013	0.020
体重指数(kg/m²)	-0.024	0.036	0.44	0.976	0.908-1.049	0.507
吸烟史(有vs无)	-0.090	0.378	0.06	0.914	0.436-1.917	0.812
饮酒史(有vs无)	0.150	0.373	0.16	1.162	0.558-2.421	0.689
高血压(有vs无)	0.192	0.371	0.27	1.212	0.582-2.524	0.608
肾结石(有vs无)	0.520	0.538	0.93	1.682	0.582-4.860	0.334
血尿酸(μmol/L)	0.001	0.001	1.14	1.001	0.999-1.003	0.285
血糖(mmol/L)	0.062	0.041	2.29	1.064	0.983-1.152	0.130

Tab.3 Multivariate logistic regression analysis of factors influencing osteoporosis

变量	回归系数	标准误	Wald χ²值	$O R$ 值	95% $C I$	$P$ 值
常数项	-6.425	1.402	20.99	0.002	0.000-0.015	<0.01
年龄(岁)	0.055	0.015	13.44	1.057	1.027-1.088	<0.01
病程(年)	0.028	0.019	2.17	1.028	0.991-1.067	0.141
痛风石(有vs无)	1.038	0.425	5.97	2.824	1.228-6.493	0.015
糖尿病(有vs无)	0.839	0.451	3.46	2.315	0.956-5.605	0.063
血肌酐(μmol/L)	0.005	0.002	6.25	1.005	1.001-1.009	0.012
超敏C反应蛋白(mg/L)	0.004	0.003	1.78	1.004	0.998-1.010	0.182

Tab.3 Multivariate logistic regression analysis of factors influencing osteoporosis

变量	回归系数	标准误	Wald χ²值	$O R$ 值	95% $C I$	$P$ 值
常数项	-6.425	1.402	20.99	0.002	0.000-0.015	<0.01
年龄(岁)	0.055	0.015	13.44	1.057	1.027-1.088	<0.01
病程(年)	0.028	0.019	2.17	1.028	0.991-1.067	0.141
痛风石(有vs无)	1.038	0.425	5.97	2.824	1.228-6.493	0.015
糖尿病(有vs无)	0.839	0.451	3.46	2.315	0.956-5.605	0.063
血肌酐(μmol/L)	0.005	0.002	6.25	1.005	1.001-1.009	0.012
超敏C反应蛋白(mg/L)	0.004	0.003	1.78	1.004	0.998-1.010	0.182

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