Gupta Surbhi, Miller Elizabeth, Merkin Sharon Stein, McMahon Maureen, Karol E Watson, FitzGerald John D
Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
Gout Urate Cryst Depos Dis. 2023 Jun;1(2):89-98. doi: 10.3390/gucdd1020009. Epub 2023 May 9.
(1) The Multi-Ethnic Study of Atherosclerosis (MESA) is a multi-center longitudinal cohort study designed to investigate the risk factors associated with the incidence of CVD. The purpose of this study is to examine the impact of gout on incident CVD. (2) Participants reporting the use of gout-specific medications (urate lowering drugs or colchicine) were compared with non-users. Kaplan-Meier survival curves and multivariable models to control for known CV risk factors evaluated hazard ratios (HR) between participants taking gout medications versus those not taking gout medications. (3) For the 6734 participants, analyses were stratified by gender owing to a gout-gender interaction. For the 164 male and 59 female participants taking gout medications, Kaplan-Meier (unadjusted) survival curves demonstrate that participants taking gout medications have higher rates of CVD than participants not taking gout medications, particularly for women. After controlling for known CV risk factors, the adjusted HR for female participants taking gout medications was 1.79 (0.99, 3.23), = 0.05; the adjusted HR for male participants on gout medications was 1.20 (0.81, 1.77), = 0.36; (4) Participants treated for gout in this study have many comorbid conditions with known CVD risk factors, making it difficult to confirm the independent effect of gout on CVD. There are a paucity of data on women with gout. These findings suggest that there is a clinically meaningful and potentially greater risk of CVD among women with gout as compared to men.
（1）动脉粥样硬化多民族研究（MESA）是一项多中心纵向队列研究，旨在调查与心血管疾病（CVD）发病相关的危险因素。本研究的目的是检验痛风对新发CVD的影响。（2）将报告使用痛风特异性药物（降尿酸药物或秋水仙碱）的参与者与未使用者进行比较。采用Kaplan-Meier生存曲线和多变量模型来控制已知的心血管风险因素，评估服用痛风药物的参与者与未服用痛风药物的参与者之间的风险比（HR）。（3）对于6734名参与者，由于痛风与性别的相互作用，分析按性别进行分层。对于164名男性和59名服用痛风药物的女性参与者，Kaplan-Meier（未调整）生存曲线表明，服用痛风药物的参与者患CVD的比率高于未服用痛风药物的参与者，尤其是女性。在控制已知的心血管风险因素后，服用痛风药物的女性参与者的调整后HR为1.79（0.99，3.23），P = 0.05；服用痛风药物的男性参与者的调整后HR为1.20（0.81，1.77），P = 0.36；（4）本研究中接受痛风治疗的参与者有许多伴有已知心血管疾病风险因素的合并症，因此难以确定痛风对心血管疾病的独立影响。关于痛风女性的数据很少。这些发现表明，与男性相比，痛风女性患心血管疾病的临床意义更大，且潜在风险更高。
