Longitudinal transition trajectory of gouty arthritis and its comorbidities: a population-based study

Abstract

The aim of the study was to investigate the longitudinal transition trajectory of gout and its comorbidities in male patients with gout in different age groups. A total of 3973 male patients who received a new diagnosis of gouty arthritis were identified from the Taiwan Longitudinal Health Insurance Database and divided into two age cohorts (<50 and ≥50 years). Each patient was individually followed from 2000 to 2009 to identify associated comorbidities, namely hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular diseases, and chronic kidney disease. Two outcome measurements of stroke and all-cause cancer were further identified until 2010. The transition trajectory was divided into the following five phenotype groups: persistent hypertension combined with a high prevalence of various gout-related comorbidities, persistent hypercholesterolemia combined with a moderate prevalence of various gout-related comorbidities, persistent low prevalence of various gout-related comorbidities, moderate to high prevalence of various gout-related comorbidities, and low to high prevalence of various gout-related comorbidities. Although the younger and older patients had a similar longitudinal transition trajectory of gout-related comorbidities, the older patients had a higher 10-year likelihood of transition from a low or moderate to a high prevalence of various gout-related comorbidities. In addition, the incidences of stroke and all-cause cancer were higher in the groups with high and moderate to high prevalences of various gout-related comorbidities than in the other groups. The occurrence of gouty arthritis in different life stages can cause cluster effects involving varying degrees of comorbidities over time. The findings of the current study can provide additional knowledge and increase clinical awareness regarding the early assessment and management of gout-related comorbidities in clinical practice.

Differential risk group of developing stroke among older women with gouty arthritis: A latent transition analysis

“…The lowest chi-square statistics, AIC, or BIC should be considered as proper latent groups and have goodness of fit. 5 The second step is to estimate the transition probabilities between the latent subgroups over time. Various criteria including the G2, AIC and BIC were also used to identify the correct model structure for the data, and the criterion of >10% was adopted as a significant transitive probability for identifying the significant transition path during the tracking period.…”

“…The favourable latent groups and model were estimated according to the identified criteria, including likelihood ratio chi‐square statistics (G2), the Akaike information criterion (AIC) and the Bayesian information criterion (BIC). The lowest chi‐square statistics, AIC, or BIC should be considered as proper latent groups and have goodness of fit . The second step is to estimate the transition probabilities between the latent subgroups over time.…”

“…The prevalence of gout has increased over the past few decades, with global prevalence ranging from 4.7/1000 to 8.4/1000 . An elevated uric acid can exacerbate monosodium urate‐induced inflammation and increase the risk of developing various comorbidities such as coronary heart disease, metabolic syndrome and renal disease . Gout patients with more comorbidity are associated with reduced health‐related quality of life and correlated with increased readmission rate, medical burden and mortality .…”

“…10,11 Our previous study further confirmed that gout-related comorbidities had various cluster effects and a variety of longitudinal transition trajectory and the clusters with high and moderate-to-high prevalence of gout-related comorbidities had high incidences of stroke and all-cause cancer compared with the other groups. 5 Nevertheless, the study only recruited male population with gout; the cluster effect and longitudinal trajectory of gouty comorbidities and its consequences were not further examined in the female population.…”

Friend or Foe? An Unrecognized Role of Uric Acid in Cancer Development and the Potential Anticancer Effects of Uric Acid-lowering Drugs

“…Gout, defined as a progressive metabolic disease characterized by symptomatic hyperuricemia, is also considered a risk factor for cancer [33,34]. Additional evidence has shown that gout increases the risk of cancer, and a higher incidence from all causes of cancer has been found in the high prevalence of various gout-related comorbidities [15,35]. A nationwide population study investigating the relationship between gout and cancer found that the annual incidence of cancer in gout patients was more than double that of the normal population [36].…”