Arthritis Research UK Primary Care Centre, Keele University, Keele, UK.
BMC Musculoskelet Disord. 2013 Apr 4;14:119. doi: 10.1186/1471-2474-14-119.
Both gout and sleep apnoea are associated with the metabolic syndrome. Hyperuricaemia is also prevalent in sleep apnoea syndrome. The objective of this study was to examine the association between gout and sleep apnoea and other sleep disorders.
Data were taken from a validated database of general practice records from nine practices in the UK between 2001 and 2008. People consulting for gout were identified via Read codes and each matched with four controls for age, gender, practice and year of gout consultation. Sleep problems and confounding comorbidities were also identified via Read codes. Medications were identified through a linked database of prescription records. The association between gout and sleep disorders was assessed using a logistic regression model, adjusting for ischaemic heart disease, hypertension, diabetes mellitus and diuretic use.
1689 individuals with gout were identified and each successfully matched to four controls. Amongst those with gout, the prevalence of any sleep problem was 4.9%, sleep problems other than sleep apnoea 4.2%, and sleep apnoea 0.7%, compared to 3.5%, 3.2% and 0.3% respectively in controls. Gout was associated with any sleep problem (odds ratio (OR) 1.44; 95% confidence interval (CI) 1.11, 1.87), sleep problems other than sleep apnoea (OR 1.36; 95% CI 1.03, 1.80), and sleep apnoea (OR 2.10; 95% CI 1.01, 4.39). On multivariable analysis, gout remained significantly associated with any sleep problem (OR 1.39; 95% CI 1.06, 1.81) and sleep problems other than sleep apnoea (OR 1.37; 95% CI 1.03, 1.82), however the association with sleep apnoea was attenuated (OR 1.48, 95% CI 0.70, 3.14).
Gout and sleep problems appear to be associated and clinicians should be aware of the co-existence of these two conditions. Larger prospective epidemiological studies are required to explore causality.
痛风和睡眠呼吸暂停均与代谢综合征有关。高尿酸血症也常见于睡眠呼吸暂停综合征。本研究旨在探讨痛风与睡眠呼吸暂停及其他睡眠障碍的关系。
本研究数据来自英国九家诊所于 2001 年至 2008 年期间建立的一个经过验证的普通实践记录数据库。通过 Read 代码识别痛风就诊者，每位痛风就诊者匹配 4 名年龄、性别、就诊诊所和就诊年份相匹配的对照者。通过 Read 代码识别睡眠问题和合并的共存疾病。通过处方记录的链接数据库识别药物。使用逻辑回归模型评估痛风与睡眠障碍之间的关联，调整缺血性心脏病、高血压、糖尿病和利尿剂使用情况的影响。
共确定了 1689 名痛风患者，每位患者均成功匹配了 4 名对照者。在痛风患者中，任何睡眠问题的患病率为 4.9%，睡眠问题（非睡眠呼吸暂停）为 4.2%，睡眠呼吸暂停为 0.7%，而对照组中相应的患病率分别为 3.5%、3.2%和 0.3%。痛风与任何睡眠问题（比值比 [OR] 1.44；95%置信区间 [CI] 1.11，1.87）、非睡眠呼吸暂停相关的睡眠问题（OR 1.36；95% CI 1.03，1.80）和睡眠呼吸暂停（OR 2.10；95% CI 1.01，4.39）相关。多变量分析显示，痛风与任何睡眠问题（OR 1.39；95% CI 1.06，1.81）和非睡眠呼吸暂停相关的睡眠问题（OR 1.37；95% CI 1.03，1.82）仍显著相关，而与睡眠呼吸暂停的相关性减弱（OR 1.48，95% CI 0.70，3.14）。
痛风和睡眠问题似乎相关，临床医生应注意这两种情况同时存在。需要更大规模的前瞻性流行病学研究来探索因果关系。
