# Risk factors for early-onset hyperuricemia and gout following laparoscopic sleeve gastrectomy: a retrospective study

## TL;DR

This study identifies risk factors for high uric acid and gout after weight-loss surgery, showing that men and those with higher pre-surgery uric acid levels are more likely to experience these issues.

## Contribution

The study provides a predictive model for hyperuricemia and gout after LSG, identifying novel risk factors like changes in body water and uric acid levels.

## Key findings

- 65.79% of patients developed hyperuricemia after LSG, with male sex and higher preoperative uric acid as key risk factors.
- Gout attacks occurred in 4.67% of patients, with male sex and a history of gout being strong predictors.
- Changes in total body water and serum uric acid levels were significant risk factors for postoperative gout attacks.

## Abstract

To investigate the risk factors associated with early-onset hyperuricemia and gout attacks after Laparoscopic Sleeve Gastrectomy (LSG).

A total of 535 obese patients who underwent LSG at Tianjin Medical University General Hospital between January 2022 and December 2024 were retrospectively enrolled according to predefined inclusion and exclusion criteria.Baseline and 1-month postoperative data—including demographic characteristics, body composition, and laboratory parameters—were collected to assess the incidence and risk factors of postoperative hyperuricemia and goutattacks.

① The incidence of postoperative hyperuricemia was 65.79% (352/535), and the gout attack rate was 4.67% (25/535). The male-to-female ratio of gout patients was 19:6, with 7 patients having a history of gout.② Multivariate analysis revealed that male sex (OR = 7.360), younger age (OR = 0.97), higher preoperative uric acid level (OR = 1.007), lower preoperative creatinine level (OR = 0.934), and higher postoperative creatinine level (OR = 1.069) were independent risk factors for postoperative hyperuricemia. The predictive model demonstrated good performance (AUC = 0.802).③ Multivariate analysis revealed that male sex (OR = 9.434), history of gout (OR = 11.654), larger change amplitude in total body water percentage (OR = 1.193, ΔTBW%), and larger change amplitude in serum uric acid level (OR = 1.018, ΔSUA%) were independent risk factors for postoperative gout attacks. The predictive model demonstrated excellent performance (AUC = 0.895).

The incidence of early hyperuricemia after LSG is high, while the incidence of gout is relatively low. Patient sex, age, preoperativeserum uric acid, preoperative creatinine, and postoperative creatinine are independent risk factors for hyperuricemia after LSG. Patient history of gout, sex, and the amplitude of changes inTBW% and serum uric acid level are independent risk factors for gout attacks after LSG.