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The Risk of Gout Among Patients With Sleep Apnea: A Matched Cohort Study
Author(s) -
BlagojevicBucknall Milica,
Mallen Christian,
Muller Sara,
Hayward Richard,
West Sophie,
Choi Hyon,
Roddy Edward
Publication year - 2019
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.40662
Subject(s) - medicine , gout , obstructive sleep apnea , hazard ratio , body mass index , comorbidity , confidence interval , cohort study , cohort , proportional hazards model , sleep apnea , retrospective cohort study , incidence (geometry) , physical therapy , pediatrics , physics , optics
Objective Obstructive sleep apnea ( OSA ) is associated with a range of serious comorbidities. This study was undertaken to investigate whether people with OSA are more likely to develop gout, in the short and long term, compared to those without OSA . Methods A matched retrospective cohort study was undertaken using the UK Clinical Practice Research Datalink. Individuals age ≥18 years who received a diagnosis of OSA between 1990 and 2010 were identified and matched on age, sex, and practice with up to 4 individuals without OSA ; follow‐up was until the end of 2015. Hazard ratios ( HR s) were estimated using Cox regression adjusted for general health, lifestyle, and comorbidity characteristics. The risk of developing gout was assessed at different time points, and the body mass index ( BMI ) category–specific results were presented. Results The study sample included 15,879 patients with OSA and 63,296 without. The median follow‐up was 5.8 years. We found that 4.9% of patients with OSA and 2.6% of patients without the disorder developed gout. The incidence rate per 1,000 person‐years was 7.83 (95% confidence interval [95% CI ] 7.29–8.40) and 4.03 (95% CI 3.84–4.23) among those with and without OSA , respectively. The adjusted HR was 1.42 (95% CI 1.29–1.56). The risk of developing gout among OSA patients compared to those without was highest 1–2 years after the index date ( HR 1.64 [95% CI 1.30–2.06]). This finding persisted among those who were overweight and obese. For those with normal BMI , the highest significant HR (2.02 [95% CI 1.13–3.62]) was observed at 2–5 years after the index date. Conclusion In this study, patients with OSA continued to be at higher risk of developing gout beyond the first year following the diagnosis. Our results further indicate that peak incidences of gout vary according to BMI .