Tung Yi-Ching, Lee Su-Shin, Tsai Wen-Chan, Lin Gau-Tyan, Chang Hsin-Wen, Tu Hung-Pin
Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
Am J Med. 2016 Nov;129(11):1219.e17-1219.e25. doi: 10.1016/j.amjmed.2016.06.041. Epub 2016 Jul 21.
We investigated the association between gout and the risk of type 2 diabetes mellitus.
Population-based representative insurance (outpatient and inpatient) claims data of 29,765 patients with gout and 59,530 controls without gout (1:2 case:control ratio) between 1998 and 2010 in Taiwan were identified. The association between gout and type 2 diabetes was evaluated using the Cox proportional hazards model. Moreover, the combined effects of sex and incident gout on the risk of type 2 diabetes were estimated.
In total, 3940 patients (13.24%) with gout and 6334 controls (10.64%) developed type 2 diabetes in the follow-up period. Multivariate analyses revealed a significant association between gout and type 2 diabetes. Compared with the control group, the adjusted hazard ratios (95% confidence intervals) for type 2 diabetes were 1.62 (1.54-1.70) in men, 1.97 (1.81-2.14) in women, and 1.70 (1.62-1.77) overall. The multiplicative interaction was β = 0.18 and P = .0001, suggesting a positive interaction between sex and incident gout. Moreover, compared with men without gout, a significantly higher risk of type 2 diabetes was noted in women without gout (adjusted relative risk [95% confidence interval], 1.17 [1.10-1.24]), men with gout (1.11 [1.06-1.16]), and women with gout (1.47 [1.37-1.57]) (P for interaction = .0058).
Gout is a strong and independent risk factor for type 2 diabetes, and female patients with gout are at a higher risk of type 2 diabetes than are male patients with gout.
我们研究了痛风与2型糖尿病风险之间的关联。
确定了1998年至2010年台湾地区基于人群的代表性保险（门诊和住院）理赔数据，其中包括29765例痛风患者和59530例无痛风对照者（病例与对照比例为1:2）。使用Cox比例风险模型评估痛风与2型糖尿病之间的关联。此外，还估计了性别和新发痛风对2型糖尿病风险的综合影响。
在随访期间，共有3940例（13.24%）痛风患者和6334例（10.64%）对照者发生了2型糖尿病。多变量分析显示痛风与2型糖尿病之间存在显著关联。与对照组相比，男性2型糖尿病的调整后风险比（95%置信区间）为1.62（1.54 - 1.70），女性为1.97（1.81 - 2.14），总体为1.70（1.62 - 1.77）。相乘交互作用为β = 0.18，P = 0.0001，表明性别与新发痛风之间存在正交互作用。此外，与无痛风男性相比，无痛风女性（调整后相对风险[95%置信区间]，1.17[1.10 - 1.24]）、有痛风男性（1.11[1.06 - 1.16]）和有痛风女性（1.47[1.37 - 1.57]）患2型糖尿病的风险显著更高（交互作用P = 0.0058）。
痛风是2型糖尿病的一个强大且独立的风险因素，痛风女性患者患2型糖尿病的风险高于痛风男性患者。
