title: Gout: an independent risk factor for all-cause and cardiovascular mortality.
abstract: OBJECTIVE
  The relation of gout and hyperuricaemia to cardiovascular diseases has been well documented. This study investigates the survival impact of both gout and hyperuricaemia.
  
  
  METHODS
  The subjects of this study comprised participants of a health screening programme conducted by the Chang Gung Memorial Hospital in Taiwan from 2000 to 2006. The status and causes of death were ascertained by the Taiwan National Death Registry 2000-07. Cox proportional hazard model was performed to examine the association.
  
  
  RESULTS
  Among 61 527 subjects, 1383 deaths (198 cardiovascular deaths) were identified, corresponding to a crude mortality rate of 4.86 deaths per 1000 person-years. Crude mortality rates were 4.50, 5.61 and 10.46 deaths per 1000 person-years for subjects with normouricaemia, hyperuricaemia and gout, respectively. Compared with subjects with normouricaemia, the hazard ratios (HRs) of all-cause mortality were 1.46 (95% CI 1.12, 1.91) for individuals with gout and 1.07 (95% CI 0.94, 1.22) for those with hyperuricaemia, respectively, after adjustments were made for age, sex, component number of metabolic syndrome and proteinuria. The adjusted HRs of cardiovascular mortality were 1.97 (95% CI 1.08, 3.59) for individuals with gout and 1.08 (95% CI 0.78, 1.51) for those with hyperuricaemia. Moreover, the risk of all-cause or cardiovascular mortality for gout remained unchanged when limiting the data to those with an estimated glomerular filtration of >60 ml/min/1.73 m(2).
  
  
  CONCLUSIONS
  This study demonstrates a link of gout, not hyperuricaemia, with a higher risk of death from all causes and cardiovascular diseases.
authors.affiliation: Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan.
authors.forename: Chang-Fu
authors.initials: CF
authors.lastname: Kuo
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
authors.forename: Shue-Fen
authors.initials: SF
authors.lastname: Luo
authors.forename: Yu-Shien
authors.initials: YS
authors.lastname: Ko
authors.forename: Yu-Sheng
authors.initials: YS
authors.lastname: Lin
authors.forename: Jawl-Shan
authors.initials: JS
authors.lastname: Hwang
authors.forename: Chi-Ming
authors.initials: CM
authors.lastname: Lin
authors.forename: Hung-Wei
authors.initials: HW
authors.lastname: Chen
authors.forename: Kuang-Hui
authors.initials: KH
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D004812:Epidemiologic Methods; D005260:Female; D005919:Glomerular Filtration Rate; D006073:Gout / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013624:Taiwan / Q000453:epidemiology