Wang Xueyan, Li Xuanlin, Wang Hongli, Chen Min, Wen Chengping, Huang Lin, Zhou Mingqian
Key Laboratory of Chinese Medicine Rheumatology of Zhejiang Province, College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road, Binjiang District, Hangzhou, China.
Key Laboratory of Chinese Medicine Rheumatology of Zhejiang Province, College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road, Binjiang District, Hangzhou, China.
Semin Arthritis Rheum. 2023 Dec;63:152273. doi: 10.1016/j.semarthrit.2023.152273. Epub 2023 Oct 7.
This meta-analysis aims to examine the general mortality risk and specific mortality risk of gout, as the incidence of the condition is on the rise but information on mortality rates remains uncertain.
The researchers conducted a search of published cohort studies on gout and mortality using Medical subject headings and keywords in PubMed, EMBASE, and Cochrane Library databases from inception to September 2022. The quality of study was evaluated using the NOS scale. Statistical analysis was performed using STATA software (version 16.0). Publication bias was assessed using funnel plots and Egger's test.
This meta-analysis included 11 cohort studies (2010-2022), covering 14,854,490 people with a follow-up time of 1.66-16 years. The pooled analysis shows increased risk of overall mortality [HR=1.23, 95 % CI (1.13-1.35), I=96.4 %, P<0.001], cardiovascular mortality [HR=1.29, 95 % CI (1.13-1.48), I=98.5 %, P<0.001], infection mortality [HR=1.24, 95 % CI (1.04-1.47), I=88.5 %, P = 0.019], and digestive system disease mortality [HR=1.42, 95 % CI (1.13-1.80), I=91.7 %, P = 0.003] in gout. Sensitivity and subgroup analysis support the findings, and publication bias was not evident.
The findings from our meta-analysis indicate that gout is associated with an increased risk of all-cause mortality, as well as mortality related to cardiovascular disease, infections, and digestive system diseases. This has important implications for clinical practice, nursing care of patients with gout, and guidance on lifestyle modifications to prevent adverse outcomes such as cardiovascular events, infections, and digestive disorders.
痛风的发病率呈上升趋势，但关于死亡率的信息仍不确定，本荟萃分析旨在研究痛风的总体死亡风险和特定死亡风险。
研究人员使用医学主题词和关键词，在PubMed、EMBASE和Cochrane图书馆数据库中检索了从建库至2022年9月发表的关于痛风与死亡率的队列研究。使用NOS量表评估研究质量。使用STATA软件（版本16.0）进行统计分析。使用漏斗图和Egger检验评估发表偏倚。
本荟萃分析纳入了11项队列研究（2010 - 2022年），涵盖14854490人，随访时间为1.66 - 16年。汇总分析显示，痛风患者的全因死亡率[HR = 1.23，95%CI（1.13 - 1.35），I = 96.4%，P < 0.001]、心血管疾病死亡率[HR = 1.29，95%CI（1.13 - 1.48），I = 98.5%，P < 0.001]、感染死亡率[HR = 1.24，95%CI（1.04 - 1.47），I = 88.5%，P = 0.019]和消化系统疾病死亡率[HR = 1.42，95%CI（1.13 - 1.80），I = 91.7%，P = 0.003]均增加。敏感性分析和亚组分析支持该结果，且未发现明显的发表偏倚。
我们的荟萃分析结果表明，痛风与全因死亡率以及心血管疾病、感染和消化系统疾病相关的死亡率增加有关。这对临床实践、痛风患者的护理以及指导生活方式改变以预防心血管事件、感染和消化系统疾病等不良后果具有重要意义。
