Kim Chi Young, Ha Jang Woo, Jung Inkyung, Han Minkyung, Ahn Sung Soo
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea.
Int J Rheum Dis. 2025 Mar;28(3):e70197. doi: 10.1111/1756-185X.70197.
Medications used for tuberculosis (TB) treatment are thought to increase uric acid levels and influence the occurrence of gout. The objective of this study was to evaluate the risk of gout in patients with TB.
We searched the South Korean National Health Claims database for incident cases of TB. After identifying patients diagnosed with gout within 6 months of TB diagnosis, the risk compared to the general population was estimated by calculating the standardized incidence ratios (SIRs). A nested case-control analysis among patients with TB was performed by matching subjects diagnosed with and without gout in a 1:5 ratio to identify the risk factors for gout.
Of the 3848 patients with gout, the proportions of males, patients aged ≥ 70 years, and those with a diagnosis within the first 2 months were 70.2%, 33.0%, and 52.8%, respectively. The incidence of gout in patients with TB was significantly higher than in the general population (overall SIR: 1.42, sex-adjusted SIR: 1.32, age-adjusted SIR: 1.04). Conditional logistic regression analysis indicated that hypertension (odd ratio [OR] 1.43, 95% confidence interval (CI) 1.31-1.58), heart failure (OR 1.19, 95% CI 1.01-1.39), chronic kidney disease (OR 2.47, 95% CI 1.99-3.06), and use of pyrazinamide (OR 1.02, 95% CI 1.02-1.02) and ethambutol (OR 1.00, 95% CI 1.00-1.01) were associated with gout.
The increased risk of gout in patients with TB and the association between comorbidities and TB medications underscore the need for higher clinical awareness in this population.
用于治疗结核病（TB）的药物被认为会提高尿酸水平并影响痛风的发生。本研究的目的是评估结核病患者患痛风的风险。
我们在韩国国家健康保险理赔数据库中搜索结核病的发病病例。在确定结核病诊断后6个月内被诊断为痛风的患者后，通过计算标准化发病率（SIR）来估计与普通人群相比的风险。对结核病患者进行巢式病例对照分析，将诊断为痛风和未患痛风的受试者按1:5的比例进行匹配，以确定痛风的危险因素。
在3848例痛风患者中，男性、年龄≥70岁的患者以及在最初2个月内确诊的患者比例分别为70.2%、33.0%和52.8%。结核病患者痛风的发病率显著高于普通人群（总体SIR：1.42，性别调整后SIR：1.32，年龄调整后SIR：1.04）。条件逻辑回归分析表明，高血压（比值比[OR]1.43，95%置信区间[CI]1.31-1.58）、心力衰竭（OR 1.19，95%CI 1.01-1.39）、慢性肾脏病（OR 2.47，95%CI 1.99-3.06）以及使用吡嗪酰胺（OR 1.02，95%CI 1.02-1.02）和乙胺丁醇（OR 1.00，95%CI 1.00-1.01）与痛风有关。
结核病患者痛风风险增加以及合并症与抗结核药物之间的关联强调了对此类人群提高临床认识的必要性。
