title: Prevalence of gout with comorbidity aggregations in southern Taiwan.
abstract: OBJECTIVE
  Comorbidity is an important concern for chronic gout patients. We evaluated the relationship between comorbidity profiles and gout in Taiwan aborigines and Taiwanese Han.
  
  
  METHODS
  We used the claims data from the Taiwan national health insurance database for 2004 to 2006. Physician-diagnosed gout and comorbidities were coded using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Total sampling from Pingtung County of southern Taiwan included 37,482 aborigines (gout cases, n=3906 and controls, n=33,576) and 37,451 Han (gout cases, n=1115 and controls, n=36,336).
  
  
  RESULTS
  In 2006, the gout prevalences were 10.42% and 2.98% (prevalence ratio [PR]=3.50) in the aborigines and Han general populations, respectively. The prevalences of uric acid nephrolithiasis and tophi were higher in aborigines (0.42% and 0.30%, respectively) than in Han (0.09% and 0.04%, respectively). When stratified by comorbidity status, the prevalences of gout were 4.49% and 27.34% in aborigines and 1.52% and 9.44% in Han (approximate PR=3.00). Similarly, the prevalence ratios of gout in the comorbidity group, compared with the non-comorbidity group, were 6.09 in aborigines and 6.23 in Han. Multivariate odds ratios [ORs] showed that hypercholesterolemia, hyperglyceridemia, essential hypertension and renal insufficiency were the common comorbidities of gout (OR≥1.63); heart failure exerted a significant effect only in aborigines (OR=1.55). For five comorbidity factors, patients with multiple comorbidities had higher gout prevalence (maximum OR=12.90).
  
  
  CONCLUSIONS
  Gout prevalence was higher in aborigines, both with and without comorbidities, than in Han. The comorbid diseases and comorbidity aggregations showed a substantial association with gout occurrence in both ethnicities.
authors.affiliation: Public Health Bureau, Pingtung County Government, Pingtung, Taiwan.
authors.forename: Fang-Yi
authors.initials: FY
authors.lastname: Tu
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung, Taiwan.
authors.forename: Gau-Tyan
authors.initials: GT
authors.lastname: Lin
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Tung
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, Taiwan. Electronic address: p915013@kmu.edu.tw.
authors.forename: Hung-Ping
authors.initials: HP
authors.lastname: Tu
authors.affiliation: Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan; Department of Occupational Medicine, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
authors.forename: Hung-Che
authors.initials: HC
authors.lastname: Chiang
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Comorbidity; Comorbidity aggregations; Gout; Prevalence