Cardiovascular Risks in Korean Patients with Gout: Analysis Using a National Health Insurance Service Database
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Sources
2.2. Study Population
2.3. Definitions of Outcomes
2.4. Assessment of Covariates
2.5. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Gout Patients (n = 3306) | Control Patients (n = 3306) | p-Value |
---|---|---|---|
Age (years), mean ± SD | 51.64 ± 12.53 | 51.36 ± 12.17 | 0.352 |
Male, n (%) | 2825 (85.45) | 2806 (84.88) | 0.511 |
BMI (kg/m2), mean ± SD | 25.10 ± 3.21 | 23.60 ± 2.30 | <0.001 ** |
Lifestyle habits | |||
Smoking, n (%) | |||
Non-smoker | 1394 (42.29) | 1271 (38.56) | |
Past smoker | 818 (24.82) | 676 (20.51) | <0.001 ** |
Current smoker | 1084 (32.89) | 1349 (40.93) | |
Alcohol intake, n (%) | |||
0–2 days/week | 2539 (76.80) | 2585 (78.19) | |
3–5 days/week | 618 (18.69) | 554 (16.76) | 0.085 |
≥6 days/week | 149 (4.51) | 167 (5.05) | |
Exercise, n (%) | |||
0–2 days/week | 2216 (67.71) | 2193 (66.86) | |
3–5 days/week | 980 (29.94) | 1011 (30.82) | 0.740 |
≥6 days/week | 77 (2.35) | 76 (2.32) | |
Laboratory findings | |||
Fasting glucose (mg/dL), mean ± SD | 100.70 ± 23.73 | 99.39 ± 25.55 | 0.027 * |
Total cholesterol (mg/dL), mean ± SD | 200.60 ± 40.07 | 197.80 ± 36.63 | 0.003 ** |
Triglyceride (mg/dL), mean ± SD | 185.20 ± 154.60 | 146.00 ± 115.60 | <0.001 ** |
HDL (mg/dL), mean ± SD | 52.46 ± 30.57 | 54.90 ± 30.64 | 0.001 ** |
LDL (mg/dL), mean ± SD | 117.60 ± 72.12 | 117.60 ± 57.71 | 0.999 |
Creatinine (mg/dL), mean ± SD | 1.24 ± 1.42 | 1.12 ± 1.08 | <0.001 ** |
GFR (mL/min), mean ± SD | 86.80 ± 35.25 | 85.38 ± 34.89 | 0.198 |
Comorbidities, n (%) | |||
Hypertension | 1310 (39.62) | 364 (11.01) | <0.001 ** |
Diabetes | 659 (19.93) | 191 (5.78) | <0.001 ** |
Hyperlipidemia | 1328 (40.17) | 288 (8.71) | <0.001 ** |
Chronic kidney disease | 97 (2.93) | 8 (0.24) | <0.001 ** |
Medication, n (%) | |||
Diuretics | 434 (13.13) | 76 (2.30) | <0.001 ** |
Beta-blocker | 339 (10.25) | 49 (1.48) | <0.001 ** |
Calcium channel blocker | 843 (25.50) | 231 (6.99) | <0.001 ** |
ACEI | 101 (3.06) | 12 (0.36) | <0.001 ** |
ARB | 696 (21.05) | 180 (5.44) | <0.001 ** |
NSAID | 3152 (95.34) | 1810 (54.75) | <0.001 ** |
COX-2 inhibitor | 86 (2.60) | 11 (0.33) | <0.001 ** |
Aspirin | 474 (14.34) | 93 (2.81) | <0.001 ** |
Steroid | 1972 (59.65) | 722 (21.84) | <0.001 ** |
Statin | 594 (17.97) | 125 (3.78) | <0.001 ** |
Colchicine | 1555 (47.04) | 0 (0) | <0.001 ** |
Hypouricemic agent | 1901 (57.50) | 1 (0.03) | <0.001 ** |
Outcome events, n (%) | |||
Ischemic heart disease | 428 (12.95) | 175 (5.29) | <0.001 ** |
Acute myocardial infarction | 56 (1.69) | 13 (0.39) | <0.001 ** |
Congestive heart failure | 123 (3.72) | 53 (1.60) | <0.001 ** |
Cerebrovascular disease | 137 (4.14) | 92 (2.78) | 0.003 ** |
Cerebral infarction | 119 (3.60) | 78 (2.36) | 0.003 ** |
Cerebral hemorrhage | 18 (0.54) | 14 (0.42) | 0.502 |
Transient ischemic attack | 72 (2.18) | 26 (0.79) | <0.001 ** |
All-cause mortality | 80 (2.42) | 80 (2.42) | 1.000 |
Cardiovascular mortality | 14 (0.42) | 12 (0.36) | 0.155 |
Outcome | HR | 95% CI | p-Value |
---|---|---|---|
Ischemic heart disease | 1.860 | 1.446–2.392 | <0.001 ** |
Acute myocardial infarction | 3.246 | 1.460–7.217 | 0.004 ** |
Congestive heart failure | 1.399 | 0.853–2.295 | 0.183 |
Cerebrovascular disease | 1.552 | 1.177–2.046 | 0.002 ** |
Cerebral infarction | 1.061 | 0.687–1.637 | 0.790 |
Cerebral hemorrhage | 0.779 | 0.283–2.145 | 0.629 |
Transient ischemic attack | 1.233 | 0.651–2.336 | 0.521 |
All-cause mortality | 1.199 | 0.737–1.952 | 0.465 |
Cardiovascular mortality | 1.377 | 0.452–4.188 | 0.573 |
Variable | IHD | AMI | CVD | |||
---|---|---|---|---|---|---|
HR (95% CI) | p-Value | HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Age | ||||||
20–39 | Reference | |||||
40–59 | 2.142 (1.393–3.294) | <0.001 ** | 3.773 (0.855–16.655) | 0.080 | 3.660 (1.821–7.357) | <0.001 ** |
≥60 | 3.544 (2.223–5.649) | <0.001 ** | 6.737 (1.405–32.315) | 0.017 * | 8.985 (4.364–18.500) | <0.001 ** |
Sex | ||||||
Female | Reference | |||||
Male | 0.975 (0.701–1.357) | 0.883 | 0.765 (0.302–1.937) | 0.572 | 0.953 (0.657–1.383) | 0.800 |
BMI (kg/m2) | ||||||
<18.5 | 1.418 (0.693–2.900) | 0.339 | 0.000 | 0.000 | 0.783 (0.287–2.135) | 0.633 |
18.5–24.9 | Reference | |||||
25–29.9 | 1.097 (0.888–1.354) | 0.392 | 0.950 (0.535–1.686) | 0.860 | 1.119 (0.871–1.439) | 0.379 |
≥30 | 1.074 (0.713–1.627) | 0.733 | 0.236 (0.031–1.784) | 0.162 | 1.203 (0.721–2.006) | 0.480 |
Lifestyle habits | ||||||
Smoking | ||||||
Non-smoker | Reference | |||||
Past smoker | 1.020 (0.713–1.617) | 0.882 | 0.916 (0.421–1.992) | 0.824 | 0.772 (0.561–1.062) | 0.111 |
Current smoker | 1.315 (1.021–1.695) | 0.034 * | 1.581 (0.787–3.174) | 0.198 | 1.054 (0.777–1.429) | 0.734 |
Alcohol intake | ||||||
0–2 days/week | Reference | |||||
3–5 days/week | 1.144 (0.891–1.467) | 0.292 | 1.174 (0.580–2.376) | 0.657 | 1.343 (0.991–1.819) | 0.057 |
≥6 days/week | 0.944 (0.609–1.461) | 0.795 | 1.841 (0.696–4.865) | 0.219 | 1.636 (1.069–2.502) | 0.023 * |
Exercise | ||||||
0–2 days/week | Reference | |||||
3–5 days/week | 0.862 (0.694–1.072) | 0.182 | 0.750 (0.399–1.411) | 0.373 | 1.099 (0.854–1.414) | 0.463 |
≥6 days/week | 1.023 (0.557–1.877) | 0.942 | 0.748 (0.101–5.547) | 0.777 | 1.147 (0.584–2.252) | 0.690 |
Laboratory findings | ||||||
Fasting glucose | ||||||
<126 mg/dL | Reference | |||||
≥126 mg/dL | 0.904 (0.641–1.274) | 0.564 | 0.526 (0.179–1.542) | 0.242 | 0.909 (0.608–1.359) | 0.641 |
Triglyceride | ||||||
<150 mg/dL | Reference | |||||
≥150 mg/dL | 1.152 (0.935–1.420) | 0.184 | 1.461 (0.810–2.636) | 0.208 | 0.992 (0.771–1.276) | 0.948 |
HDL | ||||||
≥40 mg/dL | Reference | |||||
<40 mg/dL | 0.882 (0.694–1.120) | 0.303 | 0.876 (0.456–1.685) | 0.692 | 0.788 (0.592–1.051) | 0.105 |
LDL | ||||||
<100 mg/dL | Reference | |||||
100–129 mg/dL | 1.158 (0.915–1.467) | 0.223 | 0.735 (0.333–1.620) | 0.445 | 1.040 (0.786–1.376) | 0.783 |
130–159 mg/dL | 1.146 (0.880–1.493) | 0.312 | 1.763 (0.866–3.591) | 0.118 | 0.960 (0.696–1.324) | 0.802 |
≥160 mg/dL | 0.918 (0.632–1.332) | 0.652 | 3.008 (1.368–6.618) | 0.006 ** | 0.870 (0.554–1.367) | 0.547 |
GFR | ||||||
≥90 mL/min | Reference | |||||
60–89 mL/min | 0.933 (0.681–1.279) | 0.668 | 0.443 (0.173–1.134) | 0.090 | 0.956 (0.636–1.435) | 0.827 |
30–59 mL/min | 0.766 (0.501–1.171) | 0.218 | 0.880 (0.302–2.563) | 0.815 | 1.185 (0.734–1.914) | 0.487 |
<30 mL/min | 0.998 (0.743–1.341) | 0.992 | 0.911 (0.416–1.995) | 0.816 | 1.023 (0.695–1.506) | 0.907 |
Comorbidities | ||||||
Hypertension | 1.112 (0.811–1.525) | 0.510 | 1.143 (0.472–2.765) | 0.767 | 1.154 (0.804–1.657) | 0.437 |
Diabetes | 1.158 (0.912–1.470) | 0.228 | 2.070 (1.118–3.833) | 0.021 * | 1.384 (1.056–1.815) | 0.019 * |
Hyperlipidemia | 1.060 (0.825–1.362) | 0.648 | 0.769 (0.389–1.524) | 0.452 | 1.089 (0.818–1.450) | 0.558 |
CKD | 1.460 (0.945–2.255) | 0.088 | 1.440 (0.424–4.885) | 0.559 | 1.045 (0.575–1.901) | 0.885 |
Medication | ||||||
Diuretics | 1.035 (0.795–1.348) | 0.798 | 0.991 (0.480–2.046) | 0.981 | 1.134 (0.839–1.533) | 0.413 |
Beta-blocker | 1.301 (0.987–1.715) | 0.062 | 1.132 (0.514–2.495) | 0.758 | 0.977 (0.692–1.378) | 0.893 |
CCB | 0.955 (0.728–1.252) | 0.738 | 0.978 (0.467–2.049) | 0.954 | 0.792 (0.581–1.079) | 0.140 |
ACEI | 1.132 (0.729–1.756) | 0.581 | 1.023 (0.300–3.489) | 0.971 | 0.890 (0.517–1.531) | 0.673 |
ARB | 1.155 (0.893–1.494) | 0.273 | 1.519 (0.738–3.129) | 0.256 | 1.181 (0.872–1.599) | 0.283 |
NSAID | 0.956 (0.617–1.482) | 0.841 | 3.171 (0.432–23.284) | 0.257 | 2.050 (0.960–4.377) | 0.064 |
Cox-2 inhibitor | 1.067 (0.658–1.731) | 0.793 | 0.282 (0.038–2.096) | 0.216 | 1.225 (0.749–2.002) | 0.419 |
Aspirin | 1.208 (0.939–1.555) | 0.142 | 0.825 (0.395–1.723) | 0.608 | 1.244 (0.928–1.668) | 0.144 |
Steroid | 1.015 (0.833–1.237) | 0.884 | 0.770 (0.451–1.314) | 0.338 | 1.079 (0.849–1.370) | 0.534 |
Statin | 1.355 (0.933–1.578) | 0.284 | 0.966 (0.433–2.155) | 0.933 | 0.971 (0.698–1.350) | 0.971 |
Colchicine | 1.146 (0.938–1.401) | 0.183 | 0.732 (0.415–1.290) | 0.281 | 1.202 (0.947–1.525) | 0.130 |
Hypouricemic agent | 0.867 (0.704–1.067) | 0.177 | 0.945 (0.534–1.671) | 0.846 | 0.713 (0.556–0.915) | 0.011 * |
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Moon, K.W.; Kim, M.J.; Choi, I.A.; Shin, K. Cardiovascular Risks in Korean Patients with Gout: Analysis Using a National Health Insurance Service Database. J. Clin. Med. 2022, 11, 2124. https://doi.org/10.3390/jcm11082124
Moon KW, Kim MJ, Choi IA, Shin K. Cardiovascular Risks in Korean Patients with Gout: Analysis Using a National Health Insurance Service Database. Journal of Clinical Medicine. 2022; 11(8):2124. https://doi.org/10.3390/jcm11082124
Chicago/Turabian StyleMoon, Ki Won, Min Jung Kim, In Ah Choi, and Kichul Shin. 2022. "Cardiovascular Risks in Korean Patients with Gout: Analysis Using a National Health Insurance Service Database" Journal of Clinical Medicine 11, no. 8: 2124. https://doi.org/10.3390/jcm11082124