Spanish Centre for Pharmacoepidemiologic Research (CEIFE), Almirante 28-2°, 28004, Madrid, Spain.
Arthritis Res Ther. 2011 Mar 3;13(2):R39. doi: 10.1186/ar3272.
The objective of this study was to investigate the contemporary incidence of gout, examine potential risk factors, and evaluate specific gout treatment patterns in the general population.
Using the health improvement network (THIN) UK primary care database, we estimated the incidence of gout based on 24,768 newly diagnosed gout patients among a cohort of 1,775,505 individuals aged 20 to 89 years between 2000 and 2007. We evaluated potential risk factors for incident gout in a nested case-control study with 50,000 controls frequency-matched by age, sex and calendar time. We calculated odds ratios (OR) by means of unconditional logistic regression adjusting for demographic variables, lifestyle variables, relevant medical conditions and drug exposures.
The incidence of gout per 1,000 person-years was 2.68 (4.42 in men and 1.32 in women) and increased with age. Conventional risk factors were significantly and strongly associated with the risk of gout, with multivariate ORs of 3.00 (95% confidence interval (CI)) for excessive alcohol intake (that is, more than 42 units per week), 2.34 (95% CI 2.22 to 2.47) for obesity (body mass index > = 30 kg/m2), 2.48 (95% CI 2.19 to 2.81) for chronic renal impairment, and 3.00 (95% CI 2.85 to 3.15) for current diuretic use. For other medical conditions the multivariate OR were 1.84 (95% CI 1.70 to 2.00) for heart failure, 1.45 (95% CI 1.18 to 1.79) for hypertriglyceridemia and 1.12 (95% CI 1.04 to 1.22) for psoriasis. Use of cyclosporine was associated with an OR of 3.72 (95% CI, 2.17 to 6.40). Among gout-specific therapies, allopurinol was the most frequently used with a one-year cumulative incidence of 28% in a cohort of incident gout diagnosed from 2000 to 2001. Use of gout-specific treatment has not changed over recent years except for an increase of colchicine.
The contemporary incidence of gout in UK remains substantial. In this general population cohort, associations with previously purported risk factors were evident including psoriasis, heart failure, hypertriglyceridemia, and cyclosporine therapy. Use of gout-specific treatment has remained relatively constant in recent years except for an increase of colchicine.
本研究旨在调查痛风的当代发病率，探讨潜在的危险因素，并评估普通人群中特定的痛风治疗模式。
我们利用英国健康改进网络（THIN）的初级保健数据库，根据 2000 年至 2007 年间在 1775505 名 20 至 89 岁人群中诊断出的 24768 例新诊断的痛风患者，估计痛风的发病率。我们在一个嵌套病例对照研究中评估了痛风的潜在危险因素，该研究有 50000 名与年龄、性别和日历时间匹配的对照组。我们通过无条件逻辑回归计算了比值比（OR），调整了人口统计学变量、生活方式变量、相关医疗状况和药物暴露。
每 1000 人年的痛风发病率为 2.68（男性为 4.42，女性为 1.32），并随年龄增长而增加。传统危险因素与痛风风险显著且强烈相关，多变量 OR 分别为：大量饮酒（每周超过 42 单位）为 3.00（95%置信区间[CI]为 2.22 至 2.47），肥胖（体重指数≥30kg/m2）为 2.34（95%CI 为 2.19 至 2.81），慢性肾功能不全为 2.48（95%CI 为 2.19 至 2.81），当前使用利尿剂为 3.00（95%CI 为 2.85 至 3.15）。对于其他医疗条件，多变量 OR 为心力衰竭为 1.84（95%CI 为 1.70 至 2.00），高甘油三酯血症为 1.45（95%CI 为 1.18 至 1.79），银屑病为 1.12（95%CI 为 1.04 至 1.22）。环孢素的使用与 OR 为 3.72（95%CI，2.17 至 6.40）。在痛风特异性治疗中，别嘌醇的使用最为广泛，在 2000 年至 2001 年期间确诊的痛风队列中，一年内累积发病率为 28%。近年来，除秋水仙碱的使用增加外，痛风特异性治疗的使用没有变化。
英国痛风的当代发病率仍然很高。在这个普通人群队列中，与以前认为的风险因素有关，包括银屑病、心力衰竭、高甘油三酯血症和环孢素治疗。近年来，除秋水仙碱的使用增加外，痛风特异性治疗的使用相对保持稳定。
