Gout in Older Adults: The Atherosclerosis Risk in Communities Study
Gout in Older Adults: The Atherosclerosis Risk in Communities Study
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DOI：
10.1093/gerona/glv120
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发表时间：
2016-04-01
影响因子：
5.1
通讯作者：
McAdams-DeMarco, Mara A.
中科院分区：
文献类型：
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作者：
Burke, Bridget Teevan;Koettgen, Anna;McAdams-DeMarco, Mara A.
目前尚不清楚中年的传统和遗传风险因素是否能预测老年痛风的发病。我们使用社区动脉粥样硬化风险研究来研究老年人痛风的发病率，这是一项基于美国人群的前瞻性队列研究，于1987年至1989年登记，并持续随访。从8个基因的常见尿酸盐相关单核苷酸多态性中形成遗传尿酸盐评分。采用Cox比例风险模型估计传统和遗传因素对中年人群痛风发生率的校正风险比和95%置信区间。中年至65岁的累积发病率男性为8.6%，女性为2.5%；到75岁时，累计发病率分别为11.8%和5.0%。中年时，肥胖、啤酒摄入量、蛋白质摄入量、吸烟状况、高血压、利尿剂使用和肾功能（但不包括性别）与老年时痛风风险增加有关。此外，遗传尿酸评分每增加100 μ mol/L，老年人痛风风险增加3.29倍（95%可信区间：1.63-6.63）。这些发现表明，中年的传统和遗传风险因素可能有助于识别老年时有痛风风险的人。
It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age.We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population-based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model.The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 A mu mol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63-6.63) increased gout risk in older age.These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age.