Abstract
Gout is the most prevalent inflammatory arthritis in adults. Although the link between gout and type 2 diabetes mellitus (T2DM) has been documented, our understanding of the association between urate-lowering therapy (ULT) among gout patients and T2DM development remains poor. We included 69,326 patients with new-onset gout in 2000-2011. Each case was matched randomly with 1 patient without gout during the study period, and 69,326 patients were recognized as the comparison cohort. A Cox proportional hazard regression model was used to analyze differences in the risk of T2DM development between patients with and without gout after considering related comorbidities. After adjusting for potential confounders, the case group had a higher risk of T2DM than the control cohort (adjusted hazard ratio (aHR) = 1.30, 95%confidence interval (CI) = 1.24-1.38; P < 0.001). Gout patients without appropriate ULT had significantly higher risk of T2DM development than the control cohort (aHR = 1.39; 95%CI = 1.30-1.48; P < 0.001). Among gout patients, those receiving ULT excluding probenecid (aHR = 0.80; 95%CI = 0.64-1.00), all had significantly lower risk of T2DM than gout patients without ULT (all aHR < 0.90; all P < 0.001). In this study, we found that gout increased the risk of T2DM; however, patients with any ULT exhibited a lower risk of T2DM than gout patients without any ULT (all aHR < 0.90, P < 0.001; excluding probenecid).
Highlights
Gout is the most prevalent inflammatory arthritis in adults, and its public health burden is increasing globally
We followed the diagnosis guidelines of the American College of Rheumatology criteria, which is the most widely used for the diagnosis of gout [19] as provided in Supplemental Table 1
Patients with any urate-lowering therapy (ULT) exhibited a lower risk of type 2 diabetes mellitus (T2DM) than gout patients without any ULT
Summary
Gout is the most prevalent inflammatory arthritis in adults, and its public health burden is increasing globally. It is characterized by high uric acid (UA) serum levels, which, in turn, could induce the deposition of monosodium urate crystals in the small and large joints [1]. Gout has distinct distribution globally based on prevalence and incidence rates. A high prevalence of gout has been reported in the USA, at 3.9%, between 2007 and 2008 [3], and in the developed countries, at 0.53–6.1% [4]. The prevalence of gout in Taiwan was 6.24%, with an incidence rate of 2.74 per 1,000
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