title: Independent impact of gout on the risk of diabetes mellitus among women and men: a population-based, BMI-matched cohort study.
abstract: OBJECTIVE
  Evidence on the potential independent impact of gout on the risk of diabetes is limited to a single study of men with a high cardiovascular risk profile. Our objective was to examine this relation in the general population, particularly among women.
  
  
  METHODS
  We conducted a sex-stratified matched cohort study using data from The Health Improvement Network (THIN), an electronic medical records database representative of the UK general population. Up to five non-gout individuals were matched to each case of incident gout by year of birth, year of enrolment and body mass index (BMI). Multivariate HRs for incident diabetes were calculated after additionally adjusting for smoking, alcohol consumption, physician visits, comorbidities and medication use.
  
  
  RESULTS
  Among 35 339 gout patients (72.4% men, mean age of 62.7 years), the incidence rates of diabetes in women and men were 10.1 and 9.5 cases per 1000 person-years, respectively, whereas the corresponding rates were 5.6 and 7.2 cases per 1000 person-years among 137 056 non-gout subjects. The BMI-matched univariate and multivariate HRs of diabetes were higher among women compared with those among men (1.71; 95% CI 1.51 to 1.93 vs 1.22; 95% CI 1.13 to 1.31) and (1.48; 95% CI 1.29 to 1.68 vs 1.15; 95% CI 1.06 to 1.24), respectively (p values for interaction <0.001). This sex difference persisted across age-specific subgroups.
  
  
  CONCLUSIONS
  This general population-based study suggests that gout may be independently associated with an increased risk of diabetes and that the magnitude of association is significantly larger in women than in men.
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Rho
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Na
authors.initials: N
authors.lastname: Lu
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Peloquin
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA Section of Rheumatology, Boston University, Boston, Massachusetts, USA.
authors.forename: Ada
authors.initials: A
authors.lastname: Man
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: The Clinical Epidemiology Unit, Boston University School of Medicine, Boston, Massachusetts, USA Section of Rheumatology, Boston University, Boston, Massachusetts, USA.
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Cardiovascular Disease; Epidemiology; Gout