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Patients with gout at higher risk for diabetes vs. patients with OA, controls
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Patients with primary gout, especially women, were shown to have a higher risk for developing diabetes than similarly matched patients with osteoarthritis or a non-gout control group, according to researchers at Brigham and Women’s Hospital.
Researchers identified study participants from a database of patient records provided by United HealthCare, which included longitudinal claims data on diagnoses, physician visits, procedures, laboratory blood test results and pharmacy dispensing records of more than 13 million, identity-restricted patients between January 2003 and December 2012.
Patients were separated into three cohorts: those with gout, those with osteoarthritis (OA) but not gout and those without either disease. The index date for either was the date of first dispensation of a disease-specific medication after at least 365 days of enrollment in the health plan. The non-gout comparator group comprised patients without a diagnosis of gout who had at least two physician visits after 365 days of plan enrollment.
Patient records were studied in each group to identify the first onset of diabetes. An analysis of 54,075 records for patients with gout vs. 162,225 patients with OA showed the date-matched rate ratio of incident diabetes was 1.71 for patients with gout. The rate ratio was much higher in women (2.42). Rates of diabetes were reported to be higher in the gout cohort regardless of adjustments for other confounding factors such as age, comorbidities, medications and other factors, according to the researchers.
After mean follow-up of 1.9 years, the researchers found a diabetes incidence rate of 1.9 per 100 person-years in patients with gout, compared with a 1.12 incidence rate per 100 person-years in patients with OA. Women with gout were more likely to have additional comorbidities such as hypertension, obesity and cardiovascular disease.
For comparison with the non-gout group, 66,119 patients with gout were matched to three times as many patients without gout. The incidence rate of diabetes was 1.83 per 100 person-years in patients with gout, whereas the incidence rate was 0.98 per 100 person-years among patients without gout, according to the researchers. – by Shirley Pulawski
Disclosure: Kim has received research support from Pfizer and tuition support for the Pharmacoepidemiology Program at the Harvard School of Public Health, partially funded by the Pharmaceutical Research and Manufacturers of America Foundation. Please see the full study for a list of all other authors’ relevant financial disclosures.
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