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Watch for the onset of diabetes and other cardiovascular risk factors among gout patients, particularly women. A study using US insurance claims has validated UK data that showed the same gender difference.
Kim SC, Liu J, Solomon DH. Risk of Incident Diabetes in Patients With Gout: A Cohort Study. Arthritis & Rheumatology. 2015;57:273-280. doi: 10.1002/art.38918
People with gout, particularly women, are at a significantly increased risk for type 2 diabetes. This new study by a team from Brigham & Women's Hospital in Boston validates an earlier study using UK data by researchers a few miles away, at Massachusetts General.
Involving more than 200,000 patients with and without gout in a major US insurance claims database, the study finds that diabetes develops within 2 years of a gout diagnosis in 2% of cases. Among women with gout, the incidence of diabetes is almost twice that of men (2.21 vs 1.86 per 100 person-years).
Women with gout have more comorbidities in general, including hypertension, obesity, chronic kidney disease, and heart failure. They also visit doctors more often and receive more steroid treatment.
The women with gout in the database were older than the men, and more of them were smokers.
The report comes on the heels of similar findings from a large British population study that the Mass General team published last fall.
The Brigham & Women researchers speculate that gender differences in uric acid levels and urate metabolism may explain the increased cardiovascular risks among women with gout. Inflammation due to hyperuricemia may also be an independent risk factor for hyperinsulinemia, they suggest.
The diabetes risk was also far higher among 54,075 gout patients than among 162,225 age- and gender-matched patients with osteoarthritis, they found, at 1.91 vs 1.12 per person-years. The difference among women with gout or osteoarthritis was even greater.