Effect modification of hyperlipidemia and hypertension on the association between type 2 diabetes and gout. Issue 6 (December 2020) - Tung, Yi-Ching
Highlights: Type 2 diabetes had a lower risk of incident gout, with matched general population. Type 2 diabetes alone in males had a lower risk of incident gout, but not in females. Insulin users alone was not statistically significantly associated with gout risk. Insulin users with hyperlipidemia and hypertension associated with gout risk. The aggressive management of gout risk factors in type 2 diabetes patients is important. Abstract: Aims: We evaluated the association between type 2 diabetes and gout by a retrospective cohort study. Methods: Data of 17, 259 male and 18, 318 female patients with type 2 diabetes were retrieved for the 1998–2010 period. These patients were matched to a comparison group ( n = 34, 518 and n = 36, 636, respectively) in a 1:2 ratio by age and region. Results: We found that patients with type 2 diabetes after adjustment for hyperlipidemia and hypertension had a lower risk of incident gout than the matched population (incidence rate ratio, men: 0.39 [95% CI: 0.36–0.42]; women: 0.78 [0.72–0.84]). Specifically, type 2 diabetes alone without hyperlipidemia and hypertension was associated with a reduced risk of incident gout in men (adjusted relative risk [RR]: 0.29, 95% CI: 0.22–0.39), but not in women (0.86, 95% CI: 0.55–1.36). We found that insulin users with hyperlipidemia and hypertension associated with risk of incident gout and no sex-specific differences were noted (adjusted RR, men: 1.28 [95% CI: 1.11–1.48]; women: 1.32 [95% CI: 1.14–1.53]). Specifically, insulin users alone without hyperlipidemia and hypertension were not statistically significantly associated with gout risk ( P ≥ .0954). Conclusions: The results of this study indicated that hyperlipidemia and hypertension modified the association between type 2 diabetes and gout.