183. GOUT AS A CONSEQUENCE OF SLEEP APNOEA: A MATCHED COHORT STUDY

Blagojevic-Bucknall, Milica; Mallen, Christian; Muller, Sara; Hayward, Richard; West, Sophie; Choi, Hyon; Roddy, Ed

Abstract

Background: Gout and obstructive sleep apnoea are both common problems in primary care and associated with considerable co-morbidity. Serum uric acid levels are frequently elevated in sleep apnoea patients and one previous cohort study found that people with sleep apnoea are at increased risk of gout during the first year after diagnosis. This study aimed to examine the association between sleep apnoea and subsequent development of gout over a longer follow-up period.

Methods: This was a matched retrospective cohort study undertaken in the UK Clinical Practice Research Datalink (CPRD). Individuals aged 18 years and over with an incident diagnosis of sleep apnoea between 1990 and 2010 were identified and followed-up until 2015. Each sleep apnoea case was matched to four age-, gender- and GP-practice matched controls. Incidence rates of gout were calculated per 1000 person-years and hazard ratios (HR) estimated using Cox regression adjusted for body mass index (BMI), diabetes mellitus, ischaemic heart disease, hypertension, hyperlipidaemia, diuretic use, alcohol use and smoking. Risk of incident gout was assessed at different time-points: 1, 5 and 10 years. Furthermore, analyses were stratified by BMI categories (normal BMI<25kg/m2, overweight BMI 25-30kg/m2, obese BMI ≥30kg/m2).

Results: The study sample consisted of 15,878 individuals with sleep apnoea and 63,283 controls: median follow-up was 8.03 years. 782 (5.2%) of cases and 1,640 (2.3%) of controls developed gout. Incidence rate of gout per 1000 person-years was 7.83 (95% CI 7.29, 8.40) among those with sleep apnoea and 4.00 (3.80, 4.19) among those without [adjusted HR 1.32 (1.20, 1.45)]. At 1, 2 and 5 years of follow-up, adjusted HRs for incident gout were 1.37 (1.07, 1.75), 1.41 (1.19, 1.69) and 1.36 (1.17, 1.57) respectively. Gout incidence rates per 1000 person-years were higher among those with sleep apnoea across BMI categories and increased with higher BMI in both exposure groups, however proportionately more so in the controls, resulting in both crude and adjusted HRs to decrease with increasing BMI: 1.74 (1.22, 2.48), 1.25 (1.05, 1.49), 1.23 (1.09, 1.41) for normal, overweight and obese categories.

Conclusion: The novelty of this study lies in assessing both short and long term association of sleep apnoea with incident gout in a large primary care setting population. People with sleep apnoea continued to be at higher risk of developing gout beyond the first year after sleep apnoea diagnosis. Furthermore, the independent risk of gout conferred by sleep apnoea appears to be larger in those with normal BMI.

Citation

Blagojevic-Bucknall, M., Mallen, C., Muller, S., Hayward, R., West, S., Choi, H., & Roddy, E. (2017). 183. GOUT AS A CONSEQUENCE OF SLEEP APNOEA: A MATCHED COHORT STUDY. Rheumatology, 56(suppl_2), https://doi.org/10.1093/rheumatology/kex062.184

• Journal Article Type: Article
• Online Publication Date: Apr 21, 2017
• Publication Date: 2017-04
• Deposit Date: Oct 13, 2023
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 56
• Issue: suppl_2
• DOI: https://doi.org/10.1093/rheumatology/kex062.184
• Keywords: Pharmacology (medical); Rheumatology