Department of Rheumatology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
Sci Rep. 2023 Feb 16;13(1):2756. doi: 10.1038/s41598-023-29709-3.
The incidence of gout arthritis in patients with thalassemia and the association between them was indefinite. We aimed to give epidemiological evidence regarding the association between thalassemia and gout arthritis. This retrospective cohort study extracted data relating to the risk of gout arthritis from patients diagnosed with thalassemia between 2000 and 2013. We selected the control group at a ratio of 1:4 by propensity score matching (PSM). Univariable and multivariable Cox proportional hazard regression models were performed to analyze the association between thalassemia and gout arthritis and to evaluate the hazard ratio (HR) of gout arthritis after exposure with thalassemia. The sensitivity analysis was performed to avoid the mislabeled thalassemia disease, the transfusion-dependent thalassemia was classified to compare the risk of gout arthritis. The secondary outcome for the risk of gout arthritis with antigout drugs treatment was also evaluated between study groups. In the age and sex matched cohort, the majority of thalassemia patients were women (62.03%) and aged younger than 30 years old (44.79%). There were 138 (4.2%) and 500 (3.8%) incident cases of gout arthritis in the thalassemia and non-thalassemia group. After PSM, the incidence rate, per 100 person-years, of gout arthritis was 0.48 (95% CI 0.42 to 0.56) and 0.60 (95% CI 0.51 to 0.72) in non-thalassemia individuals and patients with thalassemia, respectively. In the Cox proportional hazard regression, patients with thalassemia had no significant increase in the risk of gout arthritis (adjusted HR, 1.00; 95%CI: 0.80 to 1.25) after adjusting demographic variables and comorbidities. The Kaplan-Meier curve showed that the cumulative incidence of gout arthritis was not a significant difference in the thalassemia group than in the comparison group (p > 0.05). The sensitivity analysis showed the consistent results about the risk of gout arthritis in patients with thalassemia. Our study indicated that there was no significant increase in the risk of gout arthritis in subjects with thalassemia.Future research needs to clarify the biological mechanisms behind this connection.
地中海贫血症患者中痛风关节炎的发病率及其相关性尚不确定。本研究旨在提供有关地中海贫血症与痛风关节炎之间相关性的流行病学证据。这项回顾性队列研究从 2000 年至 2013 年期间被诊断为地中海贫血症的患者中提取了与痛风关节炎风险相关的数据。我们通过倾向评分匹配（PSM）选择了对照组，比例为 1:4。采用单变量和多变量 Cox 比例风险回归模型分析了地中海贫血症与痛风关节炎之间的关联，并评估了暴露于地中海贫血症后患痛风关节炎的风险比（HR）。进行敏感性分析以避免地中海贫血症的错误标记，将输血依赖性地中海贫血症分类以比较痛风关节炎的风险。还评估了两组患者接受抗痛风药物治疗的痛风关节炎风险的次要结局。在年龄和性别匹配的队列中，大多数地中海贫血症患者为女性（62.03%），年龄小于 30 岁（44.79%）。地中海贫血症组和非地中海贫血症组中分别有 138 例（4.2%）和 500 例（3.8%）痛风关节炎新发病例。在 PSM 后，非地中海贫血症个体和地中海贫血症患者的痛风关节炎发生率，每 100 人年分别为 0.48（95%CI 0.42 至 0.56）和 0.60（95%CI 0.51 至 0.72）。在 Cox 比例风险回归中，调整人口统计学变量和合并症后，地中海贫血症患者痛风关节炎的风险无显著增加（调整后的 HR，1.00；95%CI：0.80 至 1.25）。Kaplan-Meier 曲线显示，在地中海贫血症组与对照组之间，痛风关节炎的累积发生率无显著差异（p＞0.05）。敏感性分析显示，在地中海贫血症患者中，痛风关节炎的风险无显著差异。本研究表明，地中海贫血症患者痛风关节炎的风险无显著增加。未来的研究需要阐明两者之间关联的生物学机制。
