Gout in immigrant groups: a cohort study in Sweden

Per Wändell,Axel C Carlsson,Kristina Sundquist,Danijela Gasevic,Martin J Holzmann,Jan Sundquist,Xinjun Li,Johan Ärnlöv

doi:10.1007/s10067-016-3525-1

Abstract

Our aim was to study the association between country of birth and incidence of gout in different immigrant groups in Sweden. The study population included the whole population of Sweden. Gout was defined as having at least one registered diagnosis in the National Patient Register. The association between incidence of gout and country of birth was assessed by Cox regression, with hazard ratios (HRs) and 95% confidence intervals (95% CI), using Swedish-born individuals as referents. All models were conducted in both men and women, and the full model was adjusted for age, place of residence in Sweden, educational level, marital status, neighbourhood socio-economic status and co-morbidities. The risk of gout varied by country of origin, with highest estimates, compared to Swedish born, in fully adjusted models among men from Iraq (HR 1.82, 95% CI 1.54–2.16), and Russia (HR 1.69, 95% CI 1.26–2.27), and also high among men from Austria, Poland, Africa and Asian countries outside the Middle East; and among women from Africa (HR 2.23, 95% CI 1.50–3.31), Hungary (HR 1.98, 95% CI 1.45–2.71), Iraq (HR 1.76, 95% CI 1.13–2.74) and Austria (HR 1.70, 95% CI 1.07–2.70), and also high among women from Poland. The risk of gout was lower among men from Greece, Spain, Nordic countries (except Finland) and Latin America and among women from Southern Europe, compared to their Swedish counterparts. The increased risk of gout among several immigrant groups is likely explained by a high cardio-metabolic risk factor pattern needing attention.

Highlights

MethodsGout is the most common inflammatory arthritis where monosodium urate crystals are deposited in joints and soft tissues
0.5% were diagnosed with gout, i.e. 0.8% among men and 0.3% among women, while among second-generation immigrants, 0.3% were diagnosed with gout
We explored the risk of being diagnosed with gout in first- and second-generation immigrant men and women than their

Summary

Introduction

MethodsGout is the most common inflammatory arthritis where monosodium urate crystals are deposited in joints and soft tissues. Individuals with gout experience acute attacks of excruciating pain; and, if left untreated, gout may lead to debilitating complications such as chronic joint damage and renal insufficiency [1] All these contribute to the poor patient’s health-related quality of life [2]. There is a strong relationship between gout and hypertension and with antihypertensive diuretic treatment [5, 6], especially with thiazide diuretics [7, 8], and with other cardio-vascular diseases such as chronic heart failure [5] and chronic kidney disease [9]. Gout is associated with an increased mortality risk, mainly through the increased risk of cardio-vascular diseases, including coronary heart disease [10]

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