无症状高尿酸血症患者小肠细菌过度生长及炎症细胞因子表达水平

doi:10.19723/j.issn.1671-167X.2026.02.014

Abstract

Abstract:

Objective: To analyze the incidence of small intestinal bacterial overgrowth (SIBO) in patients with asymptomatic hyperuricemia (HUA) and the serum levels of C-reactive protein (CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in patients with asymptomatic HUA and SIBO. Methods: A total of 87 asymptomatic HUA patients and 40 healthy controls from Shanxi Fenyang Hospital from June 2023 to June 2024 were selected as the study subjects, and the baseline data, laboratory indicators were collected. Lactulose methane-hydrogen breath test (LHBT) was used to detect the occurrence of SIBO, and the asymptomatic HUA patients was divided into SIBO-positive group and SIBO-negative group according to the test results of LHBT. The positive rate of SIBO in the asymptomatic HUA patients was analyzed, and the concentrations of H₂ and CH₄, the levels of CRP, IL-1β, IL-6 and TNF-α at each time point between the asymptomatic HUA patients and the healthy controls were compared, and the levels of CRP, IL-1β, IL-6 and TNF-α were compared between the SIBO-positive group and the SIBO-negative group. Multivariate Logistic regression analysis was performed to analyze the influencing factors of SIBO in asymptomatic HUA. Spearman rank correlation analysis was used to analyze the correlation between CRP, IL-1β, IL-6 and TNF-α levels and SIBO in asymptomatic HUA patients. Results: The positive rate of SIBO in the asymptomatic HUA patients was 58.62%, which was higher than that in the healthy controls (20.00%), and the difference was statistically significant (χ²=16.431, P < 0.001). There were significant differences in exhaled H₂ concentration between the asymptomatic HUA patients and the healthy controls at 0, 30, 60 and 90 min (P < 0.05), and there was no significant difference in exhaled CH₄ concentration at each time point (P>0.05). The levels of CRP, IL-1β, IL-6 and TNF-α in the asymptomatic HUA patients were significantly higher than those in the healthy controls (P < 0.05). The serum levels of CRP, IL-1β and IL-6 in the SIBO-positive group were significantly higher than those in the SIBO-negative group (P < 0.05), while the levels of TNF-α were not significantly different between the two groups (P>0.05). Multivariate Logistic regression ana-lysis of the influencing factors of SIBO in the asymptomatic HUA showed that increased IL-1β (OR=1.332, 95%CI: 1.005-1.764, P=0.046) and increased IL-6 (OR=1.586, 95%CI: 1.216-2.069, P=0.001) were independent risk factors for SIBO in the HUA patients. In asymptomatic HUA patients with SIBO, the LHBT set value was positively correlated with serum IL-1β (r=0.594, P < 0.001). Conclusion: Asymptomatic HUA patients are more likely to develop SIBO than healthy people, and SIBO in asymptomatic HUA patients is closely related to the level of inflammatory factors, so attention should be paid to the detection and intervention of SIBO in asymptomatic HUA patients.

Key words: Hyperuricemia, Asymptomatic diseases, Small intestinal bacterial overgrowth, Inflammatory cytokines, Gastrointestinal microbiome

CLC Number:

R589

Qianying WEN, Liqing ZHANG, Anlin QIN, Xiaofeng LI. Small intestinal bacterial overgrowth and inflammatory factor expression levels in patients with asymptomatic hyperuricemia[J].Journal of Peking University (Health Sciences), 2026, 58(2): 313-318.

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References 23

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Items	Asymptomatic HUA (n=87)	Healthy control (n=40)	Statistic	P value
Gender, n(%)			χ²=0.543	0.461
Male	62 (71.26)	31 (77.50)
Female	25 (28.74)	9 (22.50)
Age/years, ${\bar x}$±s	40.11±7.65	38.13±8.17	t=-1.333	0.185
BMI/(kg/m²), ${\bar x}$±s	26.33±2.33	24.83±2.61	t=-1.394	0.167
SIBO, n(%)			χ²=16.431	＜0.001
Positive	51 (58.62)	8 (20.00)
Negative	36 (41.38)	32 (80.00)

Items	Asymptomatic HUA (n=87)	Healthy controls (n=40)	Z value	P value
H₂，M(P₂₅, P₇₅)
Baseline	7.00 (4.00, 12.00)	5.00 (4.00, 9.00)	-2.100	0.036
30 min	11.00 (6.00, 15.00)	6.00 (4.25, 11.50)	-2.676	0.007
60 min	10.00 (5.00, 16.00)	5.00 (4.00, 11.25)	-2.910	0.004
90 min	12.00 (8.00, 24.00)	8.00 (5.00, 14.00)	-3.049	0.002
CH₄，M(P₂₅, P₇₅)
Baseline	6.00 (4.00, 9.00)	6.50 (4.00, 8.00)	-0.329	0.742
30 min	7.00 (4.00, 9.00)	7.00 (5.25, 8.00)	-0.089	0.929
60 min	6.00 (4.00, 10.00)	6.00 (5.00, 8.00)	-0.723	0.470
90 min	7.00 (5.00, 12.00)	7.00 (4.00, 8.00)	-1.714	0.086

Items	Asymptomatic HUA (n=87)	Healthy controls (n=40)	Z value	P value
CRP/(mg/L)，M(P₂₅, P₇₅)	20.00 (10.00, 33.00)	5.00 (3.00, 11.00)	-7.596	＜0.001
IL-1β/(ng/L)，M(P₂₅, P₇₅)	4.67 (3.38, 6.62)	2.03 (1.45, 2.77)	-5.955	＜0.001
IL-6/(ng/L)，M(P₂₅, P₇₅)	3.42 (2.01, 6.07)	2.46 (1.22, 3.65)	-2.852	0.004
TNF-α/(ng/L)，M(P₂₅, P₇₅)	1.21 (0.81, 1.77)	0.97 (0.61, 1.23)	-2.943	0.003

Items	SIBO positive group (n=51)	SIBO negative group (n=36)	Statistics	P value
Gender			χ²=0.634	0.426
Male	38 (74.51)	24 (66.67)
Female	13 (37.25)	12 (33.33)
Age/years	40.98±5.35	38.89±10.01	t=1.144	0.258
BMI/(kg/m²)	26.14±2.20	26.60±2.50	t=-0.917	0.362
Laboratory indicators
WBC/(×10⁹/L)	7.12±1.94	7.37±2.43	t=-0.512	0.610
HGB/(g/L)	160.71±13.54	158.42±11.65	t=0.822	0.413
PLT/(×10⁹/L)	239.00±40.74	233.83±40.74	t=0.550	0.584
NLR	2.36 (1.56, 3.40)	2.11 (1.51, 2.36)	Z=1.896	0.058
ALT/(U/L)	28.45±9.05	25.66±6.50	Z=1.674	0.098
AST/(U/L)	30.35±7.81	30.28±13.59	t=0.033	0.976
BUN/(mmol/L)	5.73±1.10	5.51±1.33	t=0.820	0.415
GGT/(mmol/L)	35.63±15.19	38.22±16.28	t=-0.762	0.448
Scr/(μmol/L)	81.45±17.31	78.60±19.24	t=0.321	0.749
UA/(μmol/L)	507.94±44.72	504.25±51.96	t=0.354	0.724
TC/(mmol/L)	4.74±0.88	4.64±0.71	t=0.571	0.570
TG/(mmol/L)	3.09±0.82	4.64±0.71	t=0.739	0.462
HDL-C/(mmol/L)	1.00±0.32	1.08±0.21	t=-1.601	0.113
LDL-C/(mmol/L)	2.83±0.68	2.73±0.63	t=0.631	0.535
CRP/(mg/L)	24.00 (13.00, 36.00)	16.50 (7.25, 29.75)	Z=2.069	0.039
IL-1β/(ng/L)	5.23 (3.67, 7.21)	4.04 (3.04, 5.64)	Z=2.366	0.018
IL-6/(ng/L)	4.54 (3.18, 8.02)	2.13 (0.97, 3.53)	Z=4.456	＜0.001
TNF-α/(ng/L)	1.25 (0.88, 1.86)	1.10 (0.77, 1.74)	Z=1.418	0.156

Items	B	SE	Wald χ²	P	OR (95%CI)
CRP	-0.017	0.020	0.730	0.393	0.983 (0.946-1.022)
IL-1β	0.286	0.144	3.983	0.046	1.332 (1.005-1.764)
IL-6	0.461	0.136	11.549	0.001	1.586 (1.216-2.069)

Small intestinal bacterial overgrowth and inflammatory factor expression levels in patients with asymptomatic hyperuricemia

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