Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
Rheumatol Int. 2024 Mar;44(3):451-458. doi: 10.1007/s00296-023-05423-1. Epub 2023 Aug 18.
Previous studies have reported that thyroid dysfunction is associated with increased serum uric acid levels; however, the relationship between hyperthyroidism and incidence of clinical manifestations of gout has not been fully investigated. Therefore, this study aimed to longitudinally investigate the risk of gout in patients with hyperthyroidism. This nationwide retrospective cohort study used data from the Korean National Health Claims Database. We included 76,494 patients with hyperthyroidism and 76,542 age- and sex-matched controls. A Cox proportional hazard regression model was used to adjust for potential confounders and estimate the risk of incident gout in patients with hyperthyroidism. During a mean follow-up of 9 years, incident gout developed in 3,655 (4.8%) patients with hyperthyroidism and 3251 (4.2%) controls. Hyperthyroidism was significantly associated with increased risk of incident gout [adjusted hazard ratio (HR), 1.12; 95% confidence interval (CI) 1.07-1.18], independent of baseline metabolic profiles. The median time from the diagnosis of hyperthyroidism to the development of gout was 6 years. When stratified by age and sex, the risk of gout was still significant in the < 50-year age group (HR: 1.2, 95% CI 1.12-1.29) and males (HR: 1.21, 95% CI 1.12-1.30), but not in the older age group (> 50 years) and females. Hyperthyroidism is an important risk factor for incident gout, particularly in younger age groups (< 50 years) and males. Our results highlight the importance of continuous screening for gout in patients with hyperthyroidism.
先前的研究报告指出，甲状腺功能障碍与血清尿酸水平升高有关；然而，甲状腺功能亢进与痛风临床表现发生率之间的关系尚未得到充分研究。因此，本研究旨在纵向探讨甲状腺功能亢进患者发生痛风的风险。这项全国性回顾性队列研究使用了韩国国家健康保险索赔数据库的数据。我们纳入了 76494 例甲状腺功能亢进患者和 76542 名年龄和性别匹配的对照组。采用 Cox 比例风险回归模型调整潜在混杂因素，并估计甲状腺功能亢进患者发生痛风的风险。在平均 9 年的随访期间，3655 例（4.8%）甲状腺功能亢进患者和 3251 例（4.2%）对照组发生了痛风。甲状腺功能亢进与痛风发生的风险增加显著相关[调整后的风险比（HR），1.12；95%置信区间（CI）1.07-1.18]，独立于基线代谢特征。从甲状腺功能亢进诊断到痛风发病的中位时间为 6 年。按年龄和性别分层时，在<50 岁年龄组（HR：1.2，95%CI 1.12-1.29）和男性（HR：1.21，95%CI 1.12-1.30）中，痛风的风险仍然显著，但在年龄较大组（>50 岁）和女性中则不然。甲状腺功能亢进是痛风发生的一个重要危险因素，特别是在年龄较小的组（<50 岁）和男性中。我们的研究结果强调了对甲状腺功能亢进患者进行痛风持续筛查的重要性。
