Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies.
Obesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studies.
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DOI：
10.1186/s13075-018-1612-1
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发表时间：
2018-07-05
影响因子：
4.9
通讯作者：
Roddy E
中科院分区：
文献类型：
--
作者：
Evans PL;Prior JA;Belcher J;Mallen CD;Hay CA;Roddy E
痛风治疗仍然不理想。识别有患痛风风险的人群可能会为预防提供机会。我们的目的是评估与肥胖、高血压和利尿剂使用相关的痛风风险。我们对来自初级保健或一般人群的前瞻性和回顾性队列研究进行了系统回顾和荟萃分析，这些研究涉及肥胖、高血压或利尿剂的使用，并以痛风事件为结果。总共确定了 9923 篇文章：14 篇符合纳入标准，其中 11 篇包含适合汇总荟萃分析的数据。确定了 4 篇关于肥胖的文章，10 篇关于高血压的文章，6 篇关于利尿剂使用的文章，每项荟萃分析分别包含 4 篇、9 篇和 3 篇文章。体重指数≥30 kg/m2 的个体发生痛风的可能性是其他人的 2.24 倍（调整后相对风险 2.24（95% 置信区间）1.76–2.86）。高血压个体患痛风的可能性是血压正常个体的 1.64 (1.34–2.01) 和 2.11 (1.64–2.72) 倍（分别调整后的风险比和相对风险）。与不使用利尿剂相比，使用利尿剂患痛风的风险几乎是不使用利尿剂的 2.5 倍（调整后相对风险 2.39 (1.57–3.65)）。肥胖、高血压和利尿剂的使用是痛风发生的危险因素，与没有这些危险因素的人相比，每一项的风险都会增加一倍以上。临床医生应认识到具有这些危险因素的患者发生痛风的风险更大，并为其提供适当的管理和治疗方案。
Gout treatment remains suboptimal. Identifying populations at risk of developing gout may provide opportunities for prevention. Our aim was to assess the risk of incident gout associated with obesity, hypertension and diuretic use. We conducted a systematic review and meta-analysis of prospective and retrospective cohort studies in adults (age ≥ 18 years) from primary care or the general population, exposed to obesity, hypertension or diuretic use and with incident gout as their outcome. A total of 9923 articles were identified: 14 met the inclusion criteria, 11 of which contained data suitable for pooling in the meta-analysis. Four articles were identified for obesity, 10 for hypertension and six for diuretic use, with four, nine and three articles included respectively for each meta-analysis. Gout was 2.24 times more likely to occur in individuals with body mass index ≥ 30 kg/m2 (adjusted relative risk 2.24 (95% confidence interval) 1.76–2.86). Hypertensive individuals were 1.64 (1.34–2.01) and 2.11 (1.64–2.72) times more likely to develop gout as normotensive individuals (adjusted hazard ratio and relative risk respectively). Diuretic use was associated with almost 2.5 times the risk of developing gout compared to no diuretic use (adjusted relative risk 2.39 (1.57–3.65)). Obesity, hypertension and diuretic use are risk factors for incident gout, each more than doubling the risk compared to those without these risk factors. Patients with these risk factors should be recognised by clinicians as being at greater risk of developing gout and provided with appropriate management and treatment options.
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影响因子：
--
作者：
Bhole, Vidula;de Vera, Mary;Choi, Hyon
通讯作者：
Choi, Hyon
影响因子：
27.4
作者：
Zhang, W.;Doherty, M.;Zimmermann-Gorska, I.
通讯作者：
Zimmermann-Gorska, I.
DOI：
10.1093/gerona/glv120
发表时间：
2016-04-01
影响因子：
5.1
作者：
Burke, Bridget Teevan;Koettgen, Anna;McAdams-DeMarco, Mara A.
通讯作者：
McAdams-DeMarco, Mara A.
影响因子：
5.5
作者：
Jordan, Kelsey M.;Cameron, J. Stewart;Nuki, George
通讯作者：
Nuki, George
影响因子：
2.7
作者：
Grodzicki, T;Palmer, A;Bulpitt, CJ
通讯作者：
Bulpitt, CJ