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

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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.

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Author notes

    Authors and Affiliations

    1. Division of Quality Improvement, Joint Commission of Taiwan, 5F No. 31, Sec. 2, Sanmin Road, Banqiao District, New Taipei City, Taiwan, ROC

      Chien-Fang Huang

    2. Division of Cardiovascular Medicine, Department of Internal Medicine, Taipei Medical University – Shuang Ho Hospital, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, Taiwan, ROC

      Ju-Chi Liu

    3. Department of Internal Medicine, School of Medicine, Medical College, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei City, Taiwan, ROC

      Ju-Chi Liu

    4. Accelerated Bachelor of Science in Nursing, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC

      Hui-Chuan Huang

    5. School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC

      Hui-Chuan Huang

    6. Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, No. 35, Keyan Road, Miaoli County, Taiwan, ROC

      Shao-Yuan Chuang

    7. Taipei Cancer Center, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei City, Taiwan, ROC

      Chang-I Chen

    8. Department of Healthcare Administration, School of Management, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC

      Chang-I Chen

    9. Institute of Hospital and Health Care Administration, Community Research Center, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, 11221, Taiwan, ROC

      Kuan-Chia Lin

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    1. Chien-Fang Huang
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    Correspondence to Kuan-Chia Lin.

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    The authors report no conflicts of interest.

    Ethical standard

    The Institutional Review Board of National Taiwan University approved this study (201403ES034). The NHIRD contains data that have been deidentified for research purposes. The confidentiality of the data is maintained by the NHRI, and written consent was not required from patients for this study.

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    Chien-Fang Huang and Ju-Chi Liu have contributed equally to this article.

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    Huang, CF., Liu, JC., Huang, HC. et al. Longitudinal transition trajectory of gouty arthritis and its comorbidities: a population-based study. Rheumatol Int 37, 313–322 (2017). https://doi.org/10.1007/s00296-016-3634-9

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    • DOI: https://doi.org/10.1007/s00296-016-3634-9

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