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. 2018 Jun 1;20(1):108.
doi: 10.1186/s13075-018-1596-x.

Comorbidity in gout at the time of first diagnosis: sex differences that may have implications for dosing of urate lowering therapy

Panagiota Drivelegka  1 , Valgerdur Sigurdardottir  2   3 , Anna Svärd  3 , Lennart T H Jacobsson  2 , Mats Dehlin  2
Affiliations

Comorbidity in gout at the time of first diagnosis: sex differences that may have implications for dosing of urate lowering therapy

Panagiota Drivelegka et al. Arthritis Res Ther. .

Erratum in

Abstract

Background: The aim of this study is to examine the occurrence of comorbidities at the time of first diagnosis of gout compared with matched population controls, overall and by sex, as well as to examine the crude and age-standardized prevalence of these comorbidities in men and women with gout at first diagnosis.

Methods: A population-based study used data from Swedish national and regional registers, including 14,113 gout patients aged ≥ 20 years, with a first recorded diagnosis of gout between 1 January 2006 and 31 December 2012, and 65,782 population controls, matched by age, sex and county. Prevalence ratios (95% confidence intervals) comparing gout cases and controls were calculated, overall and by sex. Crude and age-standardized prevalence (95% confidence interval) of all comorbidities in gout patients were calculated, to show differences between sexes, taking also the higher age at diagnosis in women into account.

Results: All examined comorbidities were 1.2-2.5-fold more common in gout patients at diagnosis than in population controls in both sexes. Women with gout were on average 6 years older than men at first gout diagnosis and most comorbidities, including obesity and diuretic use, were or tended to be more frequent in women than in men. When standardizing for age, women had a higher prevalence of thromboembolism (6.6% vs 5.2%) and chronic obstructive pulmonary disease (3.1% vs 2.4%). Men, on the other hand, had a higher prevalence of coronary heart disease (9.4% vs 6.4%), atrial fibrillation (9.0% vs 6.0%), congestive heart failure (7.7% vs 6.6%) and stroke (4.1% vs 3.3%).

Conclusions: The occurrence of most comorbidities was significantly increased at first diagnosis of gout in both sexes. Women were older at diagnosis and had higher occurrence of most comorbidities, including obesity and diuretic use, factors that increase serum urate, and this needs to be taken into account when starting and optimizing urate lowering therapy. These sex differences were attenuated when standardizing for age and the occurrence of cardiovascular diseases was actually higher in men.

Keywords: Comorbidity; Epidemiology; Gender; Gout; Urate lowering treatment.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval for the study was granted by the Ethical Review Board of Gothenburg, Sweden. Informed consent from the patients was not needed as the study only involved quality register linkage and no actual handling of patients.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study design. ICD International Statistical Classification of Diseases, LISA Longitudinal Integration Database for Health Insurance and Labor Market Studies
Fig. 2
Fig. 2
Prevalence rates (95% CIs) of comorbidities in cases and controls for men and women at first gout diagnosis. CI confidence interval, COPD chronic obstructive pulmonary disease, PR prevalence ratio
See this image and copyright information in PMC

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