title: Bidirectional Association between Diabetes and Gout: the Singapore Chinese Health Study.
abstract: We aimed to prospectively investigate the bidirectional association between type 2 diabetes (T2D) and gout. We analyzed follow-up data from the Singapore Chinese Health Study, when self-reports of diagnosed diabetes and gout were enquired at follow-ups I and II. Individuals who participated in both follow-ups and were free of cardiovascular disease or cancer at follow-up I were included. For T2D to gout (analysis I), prevalent gout were further excluded (final n = 31,137). For gout to T2D (analysis II), prevalent diabetes were excluded (final n = 28,668). Cox regression models were used to estimate relative risks (RRs). In the analysis I, the RR of diabetes to incident gout (682 cases) was 0.77 (95% CI 0.60-0.97). In the analysis II, the RR of gout to incident diabetes (2223 cases) was 1.36 (1.12-1.63), but became insignificant after adjustment for hypertension and BMI (1.00; 0.83-1.21). The gout to diabetes association was modified by BMI (Pinteraction = 0.04) and hypertension (Pinteraction = 0.007), and it was marginally significant in adults with BMI<24 while significant among non-hypertensive participants, but not in their counterparts. In conclusion, our results suggest that diabetes is associated with a lower risk of incident gout, while gout is positively related to diabetes among normal weight and non-hypertensive adults.
authors.affiliation: Department of Epidemiology and Biostatistics, and MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
authors.forename: An
authors.initials: A
authors.lastname: Pan
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.|University Medicine Cluster, Division of Rheumatology, National University of Singapore and National University Health System, Singapore.
authors.forename: Gim Gee
authors.initials: GG
authors.lastname: Teng
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.|Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Duke-NUS Graduate Medical School Singapore, Singapore.|Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
mesh_terms: D044466:Asian People; D015331:Cohort Studies; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006073:Gout / Q000453:epidemiology / Q000209:etiology*; D006262:Health; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology