Association Between Gout and Incident Type 2 Diabetes Mellitus: A Retrospective Cohort Study

• Published in: The American journal of medicine Vol. 129; no. 11; pp. 1219.e17 - 1219.e25
• Main Authors: Tung, Yi-Ching, PhD, Lee, Su-Shin, MD, Tsai, Wen-Chan, MD, PhD, Lin, Gau-Tyan, MD, Chang, Hsin-Wen, PhD, Tu, Hung-Pin, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2016; Elsevier Sequoia S.A
• Subjects: Adult; Aged; Aged, 80 and over; Clinical outcomes; Cohort Studies; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Female; Gout; Gout - epidemiology; Humans; Incidence; Internal Medicine; Male; Middle Aged; Multivariate Analysis; Proportional Hazards Models; Retrospective cohort study; Retrospective Studies; Rheumatism; Risk factors; Sex; Sex Factors; Taiwan - epidemiology; Type 2 diabetes; Young Adult; Type 2 diabetes; Gout; Retrospective cohort study; Sex
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2016.06.041

Abstract Objective We investigated the association between gout and the risk of type 2 diabetes mellitus. Methods Population-based representative insurance (outpatient and inpatient) claims data of 29,765 patients with gout and 59,530 controls without gout (1:2 case:control ratio) between 1998 and 2010 in Taiwan were identified. The association between gout and type 2 diabetes was evaluated using the Cox proportional hazards model. Moreover, the combined effects of sex and incident gout on the risk of type 2 diabetes were estimated. Results In total, 3940 patients (13.24%) with gout and 6334 controls (10.64%) developed type 2 diabetes in the follow-up period. Multivariate analyses revealed a significant association between gout and type 2 diabetes. Compared with the control group, the adjusted hazard ratios (95% confidence intervals) for type 2 diabetes were 1.62 (1.54-1.70) in men, 1.97 (1.81-2.14) in women, and 1.70 (1.62-1.77) overall. The multiplicative interaction was β = 0.18 and P  = .0001, suggesting a positive interaction between sex and incident gout. Moreover, compared with men without gout, a significantly higher risk of type 2 diabetes was noted in women without gout (adjusted relative risk [95% confidence interval], 1.17 [1.10-1.24]), men with gout (1.11 [1.06-1.16]), and women with gout (1.47 [1.37-1.57]) ( P for interaction = .0058). Conclusions Gout is a strong and independent risk factor for type 2 diabetes, and female patients with gout are at a higher risk of type 2 diabetes than are male patients with gout.