Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study.
Incidence of and risk factors for nephrolithiasis in patients with gout and the general population, a cohort study.
复制标题
DOI：
10.1186/s13075-017-1376-z
复制
发表时间：
2017-07-24
影响因子：
4.9
通讯作者：
Dehlin M
中科院分区：
文献类型：
--
作者：
Landgren AJ;Jacobsson LTH;Lindström U;Sandström TZS;Drivelegka P;Björkman L;Fjellstedt E;Dehlin M
已知肾结石 (NL) 与痛风相关，但与人群相比，关于痛风 NL 风险和危险因素的比较研究很少。在这项队列研究中，我们调查了：（1）痛风（病例）和一般人群对照中 NL 的总体发病率； (2) 病例和对照中首次 NL 的风险和危险因素（常见合并症和药物）。从瑞典西部地区医疗保健数据库 (VEGA) 中确定了病例 (n = 29,968) 以及年龄匹配和性别匹配的对照 (n = 138,678)。首次 NL 的分析风险因素（合并症和当前药物使用）以及社会经济因素是从 VEGA 和其他瑞典国家登记册中检索的。对于病例，随访于 2006 年 1 月 1 日开始，或者在首次诊断痛风时开始（如果发生时间较晚），对于对照患者，则从首次诊断痛风开始。随访于死亡、移民或 2012 年 12 月 31 日结束。计算每 1000 人年的发病率 (IR) 和风险比 (HR)。对病例（无论之前的 NL）及其对照进行了发生率计算。仅计算那些先前未曾出现 NL 的患者，以首次出现 NL 作为结果的 HR。病例中有 678 起 NL 事件（IR：每 1000 人年 6.16 起事件（95% CI：5.70–6.64），对照组有 2125 起 NL 事件（IR 3.85 事件每 1000 人年（95% CI：3.69–4.02），导致年龄-性别调整后的发病率为 1.60（95% CI：1.47-1.74）。病例和对照中预测因素的点估计相似，但氯沙坦的显着相互作用仅增加对照中 NL 的风险（HR = 1.49（95% CI：1.03-2.14）。袢利尿剂使病例和对照中 NL 的风险显着降低 30-34%。痛风病例中 NL 的其他显着预测因素是男性、糖尿病和肥胖。与对照组相比，男性和肾脏疾病患者的 NL 风险增加了 60%。本文的在线版本 (doi:10.1186/s13075-017-1376-z) 包含补充材料，可供授权用户使用。
Nephrolithiasis (NL) is known to be associated with gout, although there are few comparative studies on risk and risk factors for NL in gout compared to population cohorts. In this cohort study we investigated: (1) overall incidence of NL in gout (cases) and general population controls; (2) risk and risk factors (common comorbidities and medications) for first-time NL in cases and controls separately. Cases (n = 29,968) and age-matched and sex-matched controls (n = 138,678) were identified from the regional healthcare database in western Sweden (VEGA). The analyzed risk factors (comorbidities and current medication use) for first-time NL, and socioeconomic factors were retrieved from VEGA and other national Swedish registers. For cases, follow up began on 1 January 2006 or on the first diagnosis of gout if this occurred later, and for controls on their index patient’s first diagnosis of gout. Follow up ended on death, emigration or 31 December 2012. Incidence rates (IR) per 1000 person-years and hazard ratios (HR) were calculated. The incidence calculations were performed for cases (regardless of prior NL) and their controls. HRs with first occurrence of NL as outcome were calculated only in those without previous NL. In cases there were 678 NL events (IR: 6.16 events per 1000 person-years (95% CI: 5.70–6.64) and in controls 2125 NL events (IR 3.85 events per 1000 person-years (95% CI: 3.69–4.02), resulting in an age-sex-adjusted incidence rate ratio of 1.60 (95% CI:1.47–1.74). Point estimates for predictive factors were similar in cases and controls, except for a significant interaction for losartan which increased the risk of NL only in controls (HR = 1.49 (95% CI: 1.03–2.14). Loop diuretics significantly decreased the risk of NL by 30–34% in both cases and controls. Further significant predictors of NL in gout cases were male sex, diabetes and obesity and in controls male sex and kidney disease. The risk (age and sex adjusted) of NL was increased by 60% in cases compared to controls. None of the commonly used medications increased the risk of NL in gout patients. The online version of this article (doi:10.1186/s13075-017-1376-z) contains supplementary material, which is available to authorized users.
登录
查看更多内容
DOI：
10.1136/bmj.d8190
发表时间：
2012-01-12
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Choi HK;Soriano LC;Zhang Y;Rodríguez LA
通讯作者：
Rodríguez LA
影响因子：
13.2
作者：
Kramer, HM;Curhan, G
通讯作者：
Curhan, G
影响因子：
4.9
作者：
Dehlin, Mats;Drivelegka, Panagiota;Jacobsson, Lennart T. H.
通讯作者：
Jacobsson, Lennart T. H.
影响因子：
4.9
作者：
Dehlin, Mats;Ekstrom, Emin Hoxha;Jacobsson, Lennart T. H.
通讯作者：
Jacobsson, Lennart T. H.
影响因子：
4.8
作者：
Milionis, HJ;Kakafika, AI;Elisaf, MS
通讯作者：
Elisaf, MS