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痛风患者心血管风险的区域差异:韩国一项全国性队列研究

Regional variations of cardiovascular risk in gout patients: a nationwide cohort study in Korea.

作者信息

Kim Hyun Jung, Ghang Byeongzu, Kim Jinseok, Ahn Hyeong Sik

机构信息

Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.

Division of Rheumatology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea.

出版信息

J Rheum Dis. 2023 Jul 1;30(3):185-197. doi: 10.4078/jrd.2023.0011. Epub 2023 Jun 8.

Abstract

OBJECTIVE

The extent of regional variations in cardiovascular risk and associated risk factors in patients with gout in South Korea remains unclear. Therefore, we aimed to investigate the risk of major cardiovascular events in gout patients in different regions.

METHODS

This was a nationwide cohort study based on the claims database of the Korean National Health Insurance and the National Health Screening Program. Patients aged 20 to 90 years newly diagnosed with gout after January 2012 were included. After cardiovascular risk profiles before gout diagnosis were adjusted, the relative risks of incident cardiovascular events (myocardial infarction, cerebral infarction, and cerebral hemorrhage) in gout patients in different regions were assessed.

RESULTS

In total, 231,668 patients with gout were studied. Regional differences in cardiovascular risk profiles before the diagnosis were observed. Multivariable analysis showed that patients with gout in Jeolla/Gwangju had a significantly high risk of myocardial infarction (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.021.56; p=0.03). In addition, patients with gout in Gangwon (aHR, 1.38; 95% CI, 1.091.74; p<0.01), Jeolla/Gwangju (aHR, 1.41; 95% CI, 1.191.67; p<0.01), and Gyeongsang/Busan/Daegu/Ulsan (aHR, 1.37; 95% CI, 1.191.59; p<0.01) had a significantly high risk of cerebral infarction.

CONCLUSION

We found there were regional differences in cardiovascular risk and associated risk factors in gout patients. Physicians should screen gout patients for cardiovascular risk profiles in order to facilitate prompt diagnosis and treatment.

摘要

目的

韩国痛风患者心血管风险及相关危险因素的地区差异程度尚不清楚。因此,我们旨在调查不同地区痛风患者发生主要心血管事件的风险。

方法

这是一项基于韩国国民健康保险理赔数据库和国民健康筛查计划的全国性队列研究。纳入2012年1月后新诊断为痛风的20至90岁患者。在对痛风诊断前的心血管风险特征进行调整后,评估不同地区痛风患者发生心血管事件(心肌梗死、脑梗死和脑出血)的相对风险。

结果

共研究了231,668例痛风患者。观察到诊断前心血管风险特征存在地区差异。多变量分析显示,全罗道/光州的痛风患者发生心肌梗死的风险显著较高(调整后风险比[aHR],1.27;95%置信区间[CI],1.021.56;p=0.03)。此外,江原道(aHR,1.38;95%CI,1.091.74;p<0.01)、全罗道/光州(aHR,1.41;95%CI,1.191.67;p<0.01)以及庆尚道/釜山/大邱/蔚山(aHR,1.37;95%CI,1.191.59;p<0.01)的痛风患者发生脑梗死的风险显著较高。

结论

我们发现痛风患者的心血管风险及相关危险因素存在地区差异。医生应筛查痛风患者的心血管风险特征,以便及时诊断和治疗。

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