Risk acceleration by gout on major adverse cardiovascular events and all‐cause death in patients with diabetes and chronic kidney disease

医学 痛风 内科学 肾脏疾病 危险系数 糖尿病 冲程(发动机) 比例危险模型 心肌梗塞 置信区间 物理疗法 内分泌学 机械工程 工程类
作者
Da Young Lee,Jun Sung Moon,Inha Jung,Seung Min Chung,So‐Young Park,Ji Hee Yu,Ji A Seo,Kyungdo Han,Nan Hee Kim
出处
期刊:Diabetes, Obesity and Metabolism [Wiley]
被引量:1
标识
DOI:10.1111/dom.16165
摘要

Abstract Aims We aimed to examine the impact of gout on cardiovascular disease (CVD) and mortality risk in patients with type 2 diabetes and explore whether chronic kidney disease (CKD) modifies this association. Materials and Methods Using the Korean National Health Insurance Service database, 757 378 individuals with type 2 diabetes were classified into the CKD − Gout − , CKD − Gout + , CKD + Gout − , and CKD + Gout + groups. Cox proportional hazard models were used to assess the risk of myocardial infarction (MI), ischemic stroke, and mortality, after adjusting for cardiometabolic factors. Results Over a median follow‐up of 9.3 years, 25 618, 38 691, and 78 628 individuals experienced MI, stroke, and mortality, respectively. The risk of MI or stroke progressively increased across the groups, with the highest adjusted hazard ratio (HR) in the CKD + Gout + group (HR: 1.57, 95% confidence interval [CI]: 1.46–1.69), followed by the CKD + Gout − group (HR: 1.23, 95% CI 1.20–1.26). The CKD + Gout + group showed the greatest risks for MI (HR: 1.71), stroke (HR: 1.46), and mortality (HR: 1.78). Individuals with gout alone did not exhibit a significant increase in risk compared with those without gout or CKD. Interaction analyses indicated that the effect of gout on the outcomes was more pronounced in patients with CKD. Subgroup analyses yielded consistent findings across diverse demographic and clinical characteristics. Conclusions CKD with or without gout increased the risk of CVD and mortality, with the highest risk observed in the CKD + Gout + group. The interaction between CKD and gout significantly influenced these outcomes.
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