研究痛风患者多种合并症的聚合情况，探讨不同亚组之间痛风发作的预后差异。采用层次聚类法，使用 8 种合并症在 2639 名痛风患者中识别同质亚组。对其中 463 人的急性痛风发作进行了为期一年的随访；对每个集群中痛风发作的发生率和时间进行评估，以探讨痛风发作的预后。应用二元逻辑回归来评估与痛风发作相关的因素。在基线研究中，我们确定了五个亚组（C1-C5）。 C1 (n = 671, 25%) 的特点是孤立的痛风，几乎没有合并症。 C2 (n = 258, 10%) 均为肥胖。 C3 中几乎所有的人（n = 335，13%）都患有糖尿病（99.7%）。 C4 中的所有人员（n = 938，36%）均患有血脂异常。 C5（n = 437，17%）患有心血管疾病（CVD，53%）、慢性肾病（CKD，56%）和癌症（7%）的比例最高。在随访研究中，C5 痛风发作发生率最高（71.9%）且发病最早（中位 3 个月）。 C2 的痛风发作发生率最低（52.1%）且发病最晚（中位 10 个月）。 C5 痛风复发的相对风险最高（OR = 2.09）。与痛风发作风险相关的其他因素包括痛风诊断时的年龄、痛风的持续时间、痛风石的存在以及每天吸烟≥20支香烟。我们将痛风患者分为五组，并有不同的合并症。患有 CVD、CKD 和癌症的人发生痛风发作的风险最高，应接受全面护理。© 2023。作者获得意大利内分泌学会 (SIE) 独家许可。

To study the aggregation of multiple comorbidities in people with gout and explore differences in prognosis of gout flares among different subgroups.Hierarchical clustering was performed to identify homogeneous subgroups among 2639 people with gout using eight comorbidities. A one-year follow-up of acute gout flares in 463 of these people was conducted; the incidence and the timing of gout flares in each cluster were assessed to explore prognosis of gout flares. Binary logistic regression was applied to assess factors associated with gout flares.In baseline study, we identified five subgroups (C1-C5). C1 (n = 671, 25%) was characterized by isolated gout with few comorbidities. C2 (n = 258, 10%) were all obese. Almost all people in C3 (n = 335, 13%) had diabetes (99.7%). All people in C4 (n = 938, 36%) had dyslipidemia. C5 (n = 437, 17%) had the highest proportion of cardiovascular disease (CVD, 53%), chronic kidney disease (CKD, 56%), and cancer (7%). In follow-up study, C5 had the highest incidence (71.9%) and earliest onset (median 3 months) of gout flares. C2 had the lowest incidence (52.1%) and the latest onset (median 10 months) of gout flares. The highest relative risk for gout recurrent was seen for C5 (OR = 2.09). Other factors associated with the risk of gout flares were age at diagnosis of gout, duration of gout, presence of tophi, and smoking ≥ 20 cigarettes/day.We clustered people with gout into five groups with varying comorbidities. People with CVD, CKD, and cancer had the highest risk of gout flares and should receive comprehensive care.© 2023. The Author(s), under exclusive licence to Italian Society of Endocrinology (SIE).