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Risk of incident diabetes in patients with gout: a cohort study.

ABSTRACT: Patients with hyperuricemia or gout often have metabolic syndrome. Few prospective studies have examined the risk of incident diabetes mellitus (DM) in patients with gout, and there are no data to indicate whether the risk of DM in gout differs by sex. Therefore, this cohort study was undertaken to examine the overall and sex-specific incidence rates of DM in patients with gout.Using data from a US commercial insurance plan (2003-2012), the overall and sex-specific incidence rates of DM in patients with gout (ages ?40 years) were compared to those in patients with osteoarthritis (OA). Incident DM was defined as a diagnosis of DM and at least one dispensing of an antidiabetic drug. The sex-specific effect of gout on DM risk was also examined.The primary study cohorts consisted of 54,075 patients with gout and 162,225 patients with OA, matched for age, sex, and index date. In both cohorts, the mean age of the patients was 56.2 years, and 84.8% were men. Over a mean followup of 1.9 years, the incidence rate of DM was 1.91 per 100 person-years in patients with gout and 1.12 per 100 person-years in patients with OA. Multivariable Cox models adjusted for age, comorbidities, medications, and health care utilization factors revealed that gout was associated with an increased risk of DM (hazard ratio 1.45, 95% confidence interval [95% CI] 1.37-1.54) in both sexes. The impact of gout on the risk of incident DM was greater in women (hazard ratio 1.78, 95% CI 1.51-2.09) than in men (hazard ratio 1.41, 95% CI 1.33-1.50), with a significant interaction between gout and sex in relation to the risk of incident DM (P = 0.0009).Gout was associated with an increased risk of developing DM compared to that in patients with OA after adjustment for potential confounders. In addition, the risk of incident DM associated with gout was higher among women than among men.

SUBMITTER: Kim SC

PROVIDER: S-EPMC4384181 | biostudies-literature | 2015 Jan

REPOSITORIES: biostudies-literature

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Risk of incident diabetes in patients with gout: a cohort study.

Kim Seoyoung C SC Liu Jun J Solomon Daniel H DH

Arthritis & rheumatology (Hoboken, N.J.) 20150101 1

<h4>Objective</h4>Patients with hyperuricemia or gout often have metabolic syndrome. Few prospective studies have examined the risk of incident diabetes mellitus (DM) in patients with gout, and there are no data to indicate whether the risk of DM in gout differs by sex. Therefore, this cohort study was undertaken to examine the overall and sex-specific incidence rates of DM in patients with gout.<h4>Methods</h4>Using data from a US commercial insurance plan (2003-2012), the overall and sex-speci ...[more]

PMID: 25332119

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Project description:Aims/hypothesisPeople with type 2 diabetes are at increased risk of developing obstructive sleep apnoea. However, it is not known whether people with type 1 diabetes are also at an increased risk of obstructive sleep apnoea. This study aimed to examine whether people with type 1 diabetes are at increased risk of incident obstructive sleep apnoea compared with a matched cohort without type 1 diabetes.MethodsWe used a UK primary care database, The Health Improvement Network (THIN), to perform a retrospective cohort study between January 1995 and January 2018 comparing sleep apnoea incidence between patients with type 1 diabetes (exposed) and without type 1 diabetes (unexposed) (matched for age, sex, BMI and general practice). The outcome was incidence of obstructive sleep apnoea. Baseline covariates and characteristics were assessed at the start of the study based on the most recent value recorded prior to the index date. The Cox proportional hazards regression model was used to estimate unadjusted and adjusted hazard ratios, based on a complete-case analysis.ResultsIn total, 34,147 exposed and 129,500 matched unexposed patients were included. The median follow-up time was 5.43 years ((IQR 2.19-10.11), and the mean BMI was 25.82 kg/m2 (SD 4.33). The adjusted HR for incident obstructive sleep apnoea in patients with type 1 diabetes vs those without type 1 diabetes was 1.53 (95% CI 1.25, 1.86; p<0.001). Predictors of incident obstructive sleep apnoea in patients with type 1 diabetes were older age, male sex, obesity, being prescribed antihypertensive or lipid-lowering drugs, atrial fibrillation and depression.Conclusions/interpretationIndividuals with type 1 diabetes are at increased risk of obstructive sleep apnoea compared with people without diabetes. Clinicians should suspect obstructive sleep apnoea in patients with type 1 diabetes if they are old, have obesity, are male, have atrial fibrillation or depression, or if they are taking lipid-lowering or antihypertensive drugs.

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Risk of incident diabetes in patients with gout: a cohort study.

Publications

Risk of incident diabetes in patients with gout: a cohort study.

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