Poorly controlled type 2 diabetes mellitus is associated with a decreased risk of incident gout: a population-based case-control study
Poorly controlled type 2 diabetes mellitus is associated with a decreased risk of incident gout: a population-based case-control study
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DOI：
10.1136/annrheumdis-2014-205337
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发表时间：
2015-09-01
影响因子：
27.4
通讯作者：
Meier, Christoph R.
中科院分区：
文献类型：
--
作者：
Bruderer, Saskia G.;Bodmer, Michael;Meier, Christoph R.
目的探讨2型糖尿病（T2 DM）患者发生痛风的风险与糖尿病病程、糖尿病严重程度及抗糖尿病药物治疗的关系。我们确定了1990年至2012年期间年龄≥ 18岁的痛风患者。我们为每例患者匹配一名无痛风对照患者。我们采用条件Logistic回归分析计算调整OR（adj. OR）与95%CI和调整我们的分析重要的潜在confronters.Results的研究包括7536 T2 DM病例与痛风的首次诊断。与糖尿病病程< 1年相比，糖尿病病程延长（1-3、3-6、7-9和>= 10年）与0.91的调整OR降低相关（95% CI 0.79至1.04）、0.76（95% CI 0.67至0.86）、0.70（95% CI 0.61至0.86）和0.58（95% CI 0.51至0.66）。与<7%的A1 C参考水平相比，A1 C水平升高的风险估计（7.0-7.9、8.0-8.9和>= 9%）稳步下降，调整OR为0.79（95% CI 0.72至0.86）、0.63（95% CI 0.55至0.72）和0.46（95% CI 0.40至0.53）。无论是使用胰岛素，二甲双胍，也不是磺脲类药物与改变风险的事件gout.Conclusions增加A1 C水平，但不使用抗糖尿病药物，与T2 DM患者的痛风事件的风险降低。
Objective The aim of this study was to explore the risk of incident gout in patients with type 2 diabetes mellitus (T2DM) in association with diabetes duration, diabetes severity and antidiabetic drug treatment.Methods We conducted a case-control study in patients with T2DM using the UK-based Clinical Practice Research Datalink (CPRD). We identified case patients aged >= 18 years with an incident diagnosis of gout between 1990 and 2012. We matched to each case patient one gout-free control patient. We used conditional logistic regression analysis to calculate adjusted ORs (adj. ORs) with 95% CIs and adjusted our analyses for important potential confounders.Results The study encompassed 7536 T2DM cases with a first-time diagnosis of gout. Compared to a diabetes duration < 1 year, prolonged diabetes duration (1-3, 3-6, 7-9 and >= 10 years) was associated with decreased adj. ORs of 0.91 (95% CI 0.79 to 1.04), 0.76 (95% CI 0.67 to 0.86), 0.70 (95% CI 0.61 to 0.86), and 0.58 (95% CI 0.51 to 0.66), respectively. Compared to a reference A1C level of < 7%, the risk estimates of increasing A1C levels (7.0-7.9, 8.0-8.9 and >= 9%) steadily decreased with adj. ORs of 0.79 (95% CI 0.72 to 0.86), 0.63 (95% CI 0.55 to 0.72), and 0.46 (95% CI 0.40 to 0.53), respectively. Neither use of insulin, metformin, nor sulfonylureas was associated with an altered risk of incident gout.Conclusions Increased A1C levels, but not use of antidiabetic drugs, was associated with a decreased risk of incident gout among patients with T2DM.