Objective To investigate the risk factors of frequent occurrence of gout.

Methods Baseline clinical data of gout patients from the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanjing Medical University from December 2019 to December 2020 were collected, and they were assessment by dual-energy computed tomography in the affected joints. These patients were followed during the next 12 months, and occurrence time, location and clinical manifestations of gout through online filling on the internet. According to whether the patients had frequent occurrence of gout, the patients were divided into non-frequent gout group (frequency of attacks < 2) and frequent gout group (frequency of attacks ≥2). The relationship between the volume of monosodium urate crystal deposition and the recurrence of gout were investigated.

Results A total of 129 patients were included. Of these patients, 118 participants completed the 12 months′follow-up visit and 11 patients were lost in follow-up. Compared with non-frequent gout group, patients in the frequent gout group had a longer course of disease, a higher proportion of patients with hypertension and a higher level of serum creatinine, and a larger volume of urate deposition in the attack joint(P < 0.05). The larger volume of urate deposition in joints was an independent risk factor for frequent gout, and the risk of frequent gout was increased by 2 times for increase of every 1 cm³ in urate deposition volume (OR=2.0; 95%CI, 1.00 to 3.97; P < 0.05). Receiver operating characteristic (ROC) curve showed that joint monosodium urate volume of 0.21 cm³ as cutoff value, the specificity was 59%, sensitivity was 90%.

Conclusion The monosodium urate deposition load in the joints is an independent risk factor for frequent gout. Taking monosodium urate deposition load in the joints of 0.21 cm³ measured by dual-energy CT as the standard, it is easier to identify people with early frequent attacks of gout.