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. 2016 Jan;75(1):210-7.
doi: 10.1136/annrheumdis-2014-206410. Epub 2014 Nov 14.

Comorbidities in patients with gout prior to and following diagnosis: case-control study

Chang-Fu Kuo  1 , Matthew J Grainge  2 , Christian Mallen  3 , Weiya Zhang  4 , Michael Doherty  4
Affiliations

Comorbidities in patients with gout prior to and following diagnosis: case-control study

Chang-Fu Kuo et al. Ann Rheum Dis. 2016 Jan.

Abstract

Objectives: To determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis.

Methods: There were 39 111 patients with incident gout and 39 111 matched controls identified from the UK Clinical Practice Research Data-link. The risk of comorbidity before (ORs) and after the diagnosis of gout (HRs) were estimated, adjusted for age, sex, diagnosis year, body mass index, smoking and alcohol consumption.

Results: Gout was associated with adjusted ORs (95% CIs) of 1.39 (1.34 to 1.45), 1.89 (1.76 to 2.03) and 2.51 (2.19 to 2.86) for the Charlson index of 1-2, 3-4 and ≥5, respectively. Cardiovascular and genitourinary diseases, in addition to hyperlipidaemia, hypothyroidism, anaemia, psoriasis, chronic pulmonary diseases, osteoarthritis and depression, were associated with a higher risk for gout. Gout was also associated with an adjusted HR (95% CI) of 1.41 (1.34 to 1.48) for having a Charlson index ≥1. Median time to first comorbidity was 43 months in cases and 111 months in controls. Risks for incident comorbidity were higher in cardiovascular, genitourinary, metabolic/endocrine and musculoskeletal diseases, in addition to liver diseases, hemiplegia, depression, anaemia and psoriasis in patients with gout. After additionally adjusting for all comorbidities at diagnosis, gout was associated with a HR (95% CI) for all-cause mortality of 1.13 (1.08 to 1.18; p<0.001).

Conclusions: The majority of patients with gout have worse pre-existing health status at diagnosis and the risk of incident comorbidity continues to rise following diagnosis. The range of associated comorbidities is broader than previously recognised and merits further evaluation.

Keywords: Cardiovascular Disease; Epidemiology; Gout.

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Figures

Figure 1
Figure 1
Cumulative probability of (A) having the first comorbidity in the categories of Charlson index (B) an increase in the score of Charlson index in patients with incident gout (solid line) and matched controls (dotted line).
See this image and copyright information in PMC

References

    1. Kuo CF, Grainge MJ, Mallen C, et al. . Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Ann Rheum Dis 2015;74:661–7.. - PMC - PubMed
    1. Zhang W, Doherty M, Pascual E, et al. . EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006;65:1301–11. - PMC - PubMed
    1. Terkeltaub R. Update on gout: new therapeutic strategies and options. Nat Rev Rheumatol 2010;6:30–8. - PubMed
    1. Kuo CF, Yu KH, See LC, et al. . Elevated risk of mortality among gout patients: a comparison with the national population in Taiwan. Joint Bone Spine 2011;78: 577–80. - PubMed
    1. Kuo CF, See LC, Luo SF, et al. . Gout: an independent risk factor for all-cause and cardiovascular mortality. Rheumatology (Oxford) 2010;49:141–6. - PubMed

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