Huang Chien-Chung, Huang Po-Hao, Chen Jiunn-Horng, Lan Joung-Liang, Tsay Gregory J, Lin Hsiao-Yi, Tseng Chun-Hung, Lin Cheng-Li, Hsu Chung-Yi
From the Division of Immunology and Rheumatology, Department of Internal Medicine (C-CH, P-HH, J-HC, J-LL, GJT), Department of Neurology (C-HT), and Management Office for Health Data (C-LL, C-YH), China Medical University Hospital, Taichung, Taiwan; School of Medicine (J-HC, J-LL, GJT, C-HT), Rheumatology Research Laboratory (C-CH, P-HH, J-HC, J-LL, GJT), Graduate Institute of Clinical Medical Science (C-YH), China Medical University, Taichung, Taiwan; Division of Immunology and Rheumatology, Department of Internal Medicine, Veterans General Hospital, Taichung, Taiwan (H-YL); and School of Medicine, National Yang-Ming Medical University, Taipei, Taiwan (H-YL).
Medicine (Baltimore). 2015 Dec;94(51):e2140. doi: 10.1097/MD.0000000000002140.
Previous studies indicated that gout is a risk factor of cardiovascular diseases. This study aimed to determine if patients with gout have an increased risk of deep vein thrombosis (DVT) or pulmonary embolism (PE).We used the Longitudinal Health Insurance Database, a subset of the national insurance claim dataset, which enrolled 1 million Taiwanese to identify 57,981 patients with gout and 115,961 reference subjects matched by sex, age, and entry date of diagnosis. The risk of DVT and PE was analyzed using the Cox proportional hazards model.In this Taiwanese dataset observed from 2000 to 2010, we found the incidence of DVT was 5.26 per 10 person-years in the gout cohort, which was twofold higher than the incidence of 2.63 per 10 person-years in the reference cohort. After adjusting for age, sex, and 9 comorbidities, the hazard ratio (HR) of developing DVT was 1.66 (95% confidence interval [CI] = 1.37-2.01). Among patients with gout, the youngest age group had the highest increase in the risk of developing DVT (HR [95% CI] = 2.04 [1.24-3.37] for ages 20 to 49 years, 1.80 [1.28-2.51] for ages 50 to 64 years, and 1.45 [1.11-1.91] for ages ≥65 years). The incidence of PE was about one-fifth that of DVT in gout patients, but the effect of gout on the risk was similar (HR [95% CI] = 1.53 [1.01-2.29]).Our analysis confirmed that gout increased the risk of DVT and PE. Further exploration is needed in the future.
先前的研究表明，痛风是心血管疾病的一个风险因素。本研究旨在确定痛风患者发生深静脉血栓形成（DVT）或肺栓塞（PE）的风险是否增加。我们使用了纵向健康保险数据库，它是国家保险理赔数据集的一个子集，该数据库纳入了100万台湾人，以识别出57981例痛风患者和115961例按性别、年龄和诊断入院日期匹配的对照对象。使用Cox比例风险模型分析DVT和PE的风险。在这个于2000年至2010年观察到的台湾数据集中，我们发现痛风队列中DVT的发病率为每10人年5.26例，这比对照队列中每10人年2.63例的发病率高出两倍。在调整年龄、性别和9种合并症后，发生DVT的风险比（HR）为1.66（95%置信区间[CI]=1.37-2.01）。在痛风患者中，最年轻的年龄组发生DVT的风险增加最高（20至49岁年龄组的HR[95%CI]=2.04[1.24-3.37]，50至64岁年龄组为1.80[1.28-2.51]，65岁及以上年龄组为1.45[1.11-1.91]）。痛风患者中PE的发病率约为DVT的五分之一，但痛风对风险的影响相似（HR[95%CI]=1.53[1.01-2.29]）。我们的分析证实痛风会增加DVT和PE的风险。未来需要进一步探索。
