Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Taiwan.
Biomed Res Int. 2020 Jul 28;2020:6358954. doi: 10.1155/2020/6358954. eCollection 2020.
Gout is the most prevalent inflammatory arthritis in adults. Although the link between gout and type 2 diabetes mellitus (T2DM) has been documented, our understanding of the association between urate-lowering therapy (ULT) among gout patients and T2DM development remains poor. We included 69,326 patients with new-onset gout in 2000-2011. Each case was matched randomly with 1 patient without gout during the study period, and 69,326 patients were recognized as the comparison cohort. A Cox proportional hazard regression model was used to analyze differences in the risk of T2DM development between patients with and without gout after considering related comorbidities. After adjusting for potential confounders, the case group had a higher risk of T2DM than the control cohort (adjusted hazard ratio (aHR) = 1.30, 95%confidence interval (CI) = 1.24-1.38; < 0.001). Gout patients without appropriate ULT had significantly higher risk of T2DM development than the control cohort (aHR = 1.39; 95%CI = 1.30-1.48; < 0.001). Among gout patients, those receiving ULT excluding probenecid (aHR = 0.80; 95%CI = 0.64-1.00), all had significantly lower risk of T2DM than gout patients without ULT (all aHR < 0.90; all < 0.001). In this study, we found that gout increased the risk of T2DM; however, patients with any ULT exhibited a lower risk of T2DM than gout patients without any ULT (all aHR < 0.90, < 0.001; excluding probenecid).
痛风是成年人中最常见的炎症性关节炎。虽然已经有文献证明了痛风与 2 型糖尿病（T2DM）之间的联系，但我们对痛风患者降尿酸治疗（ULT）与 T2DM 发展之间的关联的理解仍然有限。我们纳入了 2000 年至 2011 年间新诊断的痛风患者 69326 例。每个病例在研究期间随机匹配 1 例无痛风患者，共识别出 69326 例患者作为对照组。采用 Cox 比例风险回归模型分析考虑相关合并症后，痛风患者和无痛风患者发生 T2DM 的风险差异。调整潜在混杂因素后，病例组发生 T2DM 的风险高于对照组（校正后风险比[aHR] = 1.30，95%置信区间[CI] = 1.24-1.38；<0.001）。未接受适当 ULT 的痛风患者发生 T2DM 的风险明显高于对照组（aHR = 1.39；95%CI = 1.30-1.48；<0.001）。在痛风患者中，接受非丙磺舒 ULT 的患者（aHR = 0.80；95%CI = 0.64-1.00）发生 T2DM 的风险明显低于未接受 ULT 的痛风患者（所有 aHR <0.90；所有<0.001）。在这项研究中，我们发现痛风增加了 T2DM 的风险；然而，与未接受任何 ULT 的痛风患者相比，任何 ULT 的患者发生 T2DM 的风险均较低（所有 aHR <0.90，<0.001；排除丙磺舒）。
