痛风发病率上升和合并症负担增加：一项超过 20 年的基于人群的研究。
The Rising Incidence of Gout and the Increasing Burden of Comorbidities: A Population-based Study over 20 Years.
机构信息
From Department of Rheumatology, Kasr Alainy Hospital, Cairo University, Cairo, Egypt; Division of Rheumatology, Mayo Clinic College of Medicine; Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine; Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, Minnesota; Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, New York; Division of Rheumatology, Augusta University, Atlanta, Georgia; Department of Emergency Medicine, Vanderbilt University, Nashville, Tennessee, USA.
M.M. Elfishawi, MD, Internal Medicine Resident, Icahn School of Medicine at Mount Sinai; N. Zleik, MD, Internal Medicine Resident, Division of Rheumatology, Augusta University; Z. Kvrgic, CCRP, Study coordinator, Mayo Clinic; C.J. Michet Jr MD, Consultant, Mayo Clinic; C.S. Crowson, MS, Associate Professor, Mayo Clinic; E.L. Matteson, MD, MPH, Consultant, Mayo Clinic; T. Bongartz, MD, MS, Vanderbilt University.
出版信息
J Rheumatol. 2018 Apr;45(4):574-579. doi: 10.3899/jrheum.170806. Epub 2017 Dec 15.
OBJECTIVE
To examine the incidence of gout over the last 20 years and to evaluate possible changes in associated comorbid conditions.
METHODS
The medical records were reviewed of all adults with a diagnosis of incident gout in Olmsted County, Minnesota, USA, during 2 time periods (January 1, 1989-December 31, 1992, and January 1, 2009-December 31, 2010). Incident cases had to fulfill at least 1 of 3 criteria: the American Rheumatism Association 1977 preliminary criteria for gout, the Rome criteria, or the New York criteria.
RESULTS
A total of 158 patients with new-onset gout were identified during 1989-1992 and 271 patients during 2009-2010, yielding age- and sex-adjusted incidence rates of 66.6/100,000 (95% CI 55.9-77.4) in 1989-1992 and 136.7/100,000 (95% CI 120.4-153.1) in 2009-2010. The incidence rate ratio was 2.62 (95% CI 1.80-3.83). At the time of their first gout flare, patients diagnosed with gout in 2009-2010 had higher prevalence of comorbid conditions compared with 1989-1992, including hypertension (69% vs 54%), diabetes mellitus (25% vs 6%), renal disease (28% vs 11%), hyperlipidemia (61% vs 21%), and morbid obesity (body mass index ≥ 35 kg/m; 29% vs 10%).
CONCLUSION
The incidence of gout has more than doubled over the recent 20 years. This increase together with the more frequent occurrence of comorbid conditions and cardiovascular risk factors represents a significant public health challenge.
目的
调查过去 20 年来痛风的发病率，并评估相关合并症的可能变化。
方法
回顾美国明尼苏达州奥姆斯特德县在两个时间段（1989 年 1 月 1 日至 1992 年 12 月 31 日和 2009 年 1 月 1 日至 2010 年 12 月 31 日）中诊断为新发痛风的所有成年人的病历。新发病例必须符合以下至少 1 项标准：美国风湿病学会 1977 年痛风初步标准、罗马标准或纽约标准。
结果
1989-1992 年期间共发现 158 例新发痛风患者，2009-2010 年期间共发现 271 例，年龄和性别调整后的发病率分别为 1989-1992 年的 66.6/100000（95%CI 55.9-77.4）和 2009-2010 年的 136.7/100000（95%CI 120.4-153.1）。发病率比为 2.62（95%CI 1.80-3.83）。在首次痛风发作时，2009-2010 年诊断为痛风的患者与 1989-1992 年相比，合并症的患病率更高，包括高血压（69%比 54%）、糖尿病（25%比 6%）、肾脏疾病（28%比 11%）、高脂血症（61%比 21%）和病态肥胖（身体质量指数≥35kg/m；29%比 10%）。
结论
在过去的 20 年中，痛风的发病率增加了一倍以上。这种增加加上更频繁的合并症和心血管危险因素的发生，代表了一个重大的公共卫生挑战。
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