The Risk of Gout Among Patients With Sleep Apnea: A Matched Cohort Study

Blagojevic‐Bucknall, Milica; Mallen, Christian; Müller, Sara; Hayward, Richard; West, Sophie; Choi, Hyon K.; Roddy, Edward

doi:10.1002/art.40662

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…The absence of an overall association between OSA and gout in our study contrasts with a 1.5-fold increased risk of gout with OSA that was reported by two previous studies [4,9] which had used the same data source, i.e., the CPRD GOLD database, or a data source (THIN) that partly overlaps with CPRD [19]. Table 3 shows that this difference can be largely explained by more comprehensive statistical adjustment for potential confounding in the current study, in particular for renal impairment, as measured by eGFR and READ codes, and heart failure.…”

Section: Discussioncontrasting

confidence: 99%

“…Two prospective studies in large United Kingdom (UK) primary care databases have demonstrated a 1.5fold increased risk of developing gout among patients with OSA [4,9] with the overall risk peaking 1 to 2 years after OSA diagnosis [9]. While both papers statistically adjusted their analyses for body mass index (BMI), type 2 diabetes mellitus, ischemic heart disease, hypertension, the use of diuretics of an unspecified class, and alcohol consumption, renal impairment was either ignored or considerably under-recorded [4].…”

Section: Introductionmentioning

confidence: 99%

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Obstructive sleep apnea and the risk of gout: a population-based case-control study

et al. 2020

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Background: Patients with obstructive sleep apnea (OSA) might be at risk of gout because of pathophysiological mechanisms that can lead to hyperuricemia and eventually gout or because of shared risk factors between both diseases. The objective of the present study was to investigate the risk of gout in patients with OSA. Methods: A population-based case-control study using the UK Clinical Practice Research Datalink GOLD including all patients aged 40 years and older with a first diagnosis of gout between 1987 and 2014. Gout cases were matched by year of birth, sex, and practice to non-gout controls. Conditional logistic regression estimated the risk of gout with an earlier diagnosis of OSA. Analyses were adjusted for lifestyle factors, comorbidities, and recent drug use. Results: One hundred eleven thousand five hundred nine cases were matched with 210,241 controls. Patients with OSA were at increased risk of gout (OR 1.86; 95%CI (1.71-2.02). However, this association disappeared (OR 1.05; 95% CI 0.96-1.16) after adjustment for smoking status, body mass index (BMI), alcohol use, a history of heart failure, diabetes mellitus, renal function, and recent use of diuretics and other medications. Among females with OSA and patients with OSA associated with heart failure, renal impairment, or higher BMI, the risk of gout was however still increased when compared to the total control population. Conclusion: This study showed that the observed association between OSA and gout disappeared after adjustment.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Obstructive sleep apnea and the risk of gout: a population-based case-control study

et al. 2020

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“…Later, in 2018 Blagojevic-Bucknall et al [3], analyzed the data of 15879 patients with OSA (in comparison with 63296 controls), and found that the frequency of gout was almost twice as high in patients with OSA. A meta-analysis by Tingting Shi et al [1], published in 2019, included 18 independent studies and 157 607 patients (32395 with OSA, 125212 without OSA, of which 12 262 with gout).…”

Section: Literature Review 1 Population-based Studiesmentioning

confidence: 99%

“…Gout is one of the most common rheumatic diseases in the world, which affects about 1.14 % of the general population in China [1], and from 1.4 to 2.5 in other countries [2][3][4]. According to different sources, the incidence of OSA in the general population is 4-10 % [5].…”

Section: Introductionmentioning

confidence: 99%

“…OSA episode is characterized by a major upper airway collapse during sleep and subsequent decrease in blood oxygen saturation. Some studies showed that hypoxemia in OSA can affect the levels of blood uric acid, or lead to the increase in gout incidence or aggravation of symptoms in gout patients [3]. The purpose of this paper is to explore the relationship between gout and OSA, to provide new ideas for diagnostic and treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

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Sleep Apnea in Gout Patients: Underlying Mechanisms and Shared Patient Subtypes

Jianchun¹,

Zhou²,

Wei³

et al. 2020

EUREKA: Health Sciences

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Acute and chronic inflammation in gout causes permanent tissue damage, leads to restricted mobility and significantly reduces the quality of life. Obstructive sleep apnea (OSA) is a breath disordered sleep disease, which is a risk factor for respiratory, cardiovascular and cerebrovascular complications, nephropathy and other diseases. The aim of this paper was to explore the underlying mechanisms and shared pathways, targets and biomarkers of sleep apnea and gout. aiming at providing clear evidence about whether OSAS patients have higher serum uric acid levels and more susceptible to gout. Materials and methods. We conducted this literature analysis on relevant studies, which were identified via electronic databases from inception to May 30, 2020. Study selection was conducted according to predesigned criteria, and two authors independently extracted data from included studies. Results. In the period from 2010 to 2020, 4 large-scale population-based studies were conducted to prove that OSA can affect the level of uric acid, resulting in increased incidence of gout in OSA patients. Only one big population-based study during 2010-2020 assessed the development of OSA against the background of gout. The data from these studies showed an undoubted relationship between the two diseases, but to date it is not completely known how much it is due to common risk factors and how interlinked the development mechanisms are. Conclusions. Relationship between OSA, gout, and pro-inflammatory/metabolic disorders is therefore complex; with some recent studies indicate different mechanisms may play a role in the development of OSA-gout combination. The inconsistency in results may indicate the presence of several patient profiles or subtypes with gout-OSA comorbidity: combined with metabolic syndrome (most common), combined with renal dysfunction without obesity, and others (dietary violations, genetic diseases, acidosis). This paper reviews the research progress on the relationship between the epidemiological characteristics of OSA and the incidence of gout, with the insight into pathogenetic mechanisms of comorbidity.

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