Relationship between serum urate concentration and clinically evident incident gout: an individual participant data analysis
Relationship between serum urate concentration and clinically evident incident gout: an individual participant data analysis
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DOI：
10.1136/annrheumdis-2017-212288
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发表时间：
2018-07-01
影响因子：
27.4
通讯作者：
Merriman, Tony R.
中科院分区：
文献类型：
--
作者：
Dalbeth, Nicola;Phipps-Green, Amanda;Merriman, Tony R.
Objectives To provide estimates of cumulative incidence of gout according to baseline serum urate.Methods Using individual participant data from four publicly available cohort（Atherosclerosis Risk in Communities Study，Coronary Artery Risk Development in Young Adults Study，and both the Original and Offspring cohort of the Frachial Heart Study），the cumulative incidence of clinically evident gout was calculated according to baseline serum urate category.考克斯比例风险模型被用来评估基线尿酸盐类事件gout.Results的风险的关系，这项分析包括18 889名参与者在基线痛风免费，平均（SD）11.2（4.2）年和212 363总患者年的后续行动。每个时间点的累积发生率根据基线血清尿酸盐浓度而变化，≥ 10 mg/dL的15年累积发生率（95% CI）范围为1.1%（0.9 - 1.4）。与基线相比，血清尿酸盐= 10 mg/dL为64。结论血清尿酸盐水平是痛风发病的一个强非线性浓度依赖性预测因子。尽管如此，只有大约一半的血清尿酸浓度>= 10 mg/dL的人在15年内发展为临床上明显的痛风，这意味着长期高尿酸血症和其他因素在痛风发病机制中的作用。
Objectives To provide estimates of the cumulative incidence of gout according to baseline serum urate.Methods Using individual participant data from four publicly available cohorts (Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, and both the Original and Offspring cohorts of the Framingham Heart Study), the cumulative incidence of clinically evident gout was calculated according to baseline serum urate category. Cox proportional hazards modelling was used to evaluate the relation of baseline urate categories to risk of incident gout.Results This analysis included 18 889 participants who were gout-free at baseline, with mean (SD) 11.2 (4.2) years and 212 363 total patient-years of follow-up. The cumulative incidence at each time point varied according to baseline serum urate concentrations, with 15-year cumulative incidence (95% CI) ranging from 1.1% (0.9 to 1.4) for = 10 mg/dL. Compared with baseline serum urate = 10 mg/dL was 64.Conclusions Serum urate level is a strong non-linear concentration-dependent predictor of incident gout. Nonetheless, only about half of those with serum urate concentrations >= 10mg/dL develop clinically evident gout over 15 years, implying a role for prolonged hyperuricaemia and additional factors in the pathogenesis of gout.