Gout and Hypothyroidism in the Elderly: an Observational Cohort Study Using U.S. Medicare Claims Data
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Given the known association of hypothyroidism and hyperuricemia, a link between gout and hypothyroidism has long been suspected, but rarely investigated. Two small studies in hospitalized patients1 or at a single medical center2 suggested a higher risk of hypothyroidism in people with gout. These studies included small samples, controlled for only select demographic variables and none focused on the elderly, the population at the highest risk of hypothyroidism. Well-designed studies that can control for potential confounders can provide a robust estimate of this potential association are needed. Our objective was to examine whether gout, the most common inflammatory arthritis in adults, was associated with an increase in the risk of incident hypothyroidism in adults 65 years or older.
We used the 5% random Medicare claims data to conduct this cohort study. Patients were considered eligible for this analysis, if they received Medicare fee-for-service (parts A or B)...
We thank Dr. Jeffrey Curtis of the UAB Division of Rheumatology, who permitted us to re-use the 5% Medicare data. We thank patients at the University of Alabama gout clinic for asking us questions about comorbidities of gout and whether gout may be related to their other conditions, which prompted us to ask this question.
This material is the result of work supported by research funds from the Division of Rheumatology at the University of Alabama at Birmingham and the resources and use of facilities at the Birmingham VA Medical Center, Birmingham, Alabama, USA.
Role of the Funder/Supporter
The funding body did not play any role in the design, collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Mr. Cleveland had full access to all of the data in the study and takes the responsibility for the integrity of the data and accuracy of the data analysis. He was supervised by Dr. Singh, who reviewed all results.
Study Concept and Design: Singh.
Data acquisition, analysis and interpretation of results: Singh, Cleveland
Drafting of the manuscript: Singh
Critical revision of the manuscript for important intellectual content: Singh, Cleveland
Statistical analysis: Cleveland
Obtained Funding: Singh
Administrative, technical or material support: Singh
Study Supervision: Singh
Compliance with Ethical Standards
Conflict of Interest
JAS has received research grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta/Horizon and Allergan pharmaceuticals, WebMD, UBM LLC and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA, Inc., a 501 (c)(3) entity. JAS is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology’s (ACR) Annual Meeting Planning Committee (AMPC); Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. JAS is the editor and Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. DC has no conflicts to declare. There are no non-financial competing interests for any of the authors.
Ethics/IRB Approval and Consent to Participate
The University of Alabama at Birmingham’s Institutional Review Board approved this study and waived the need for informed consent for this database study. All investigations were conducted in conformity with ethical principles of research.
- 1.Durward WF. Letter: Gout and hypothyroidism in males. Arthritis Rheum 1976;19:123.Google Scholar