title: Alcohol-related diseases and alcohol dependence syndrome is associated with increased gout risk: A nationwide population-based cohort study.
abstract: OBJECTIVE
  Alcohol intake is strongly associated with hyperuricemia, which may cause gout. This study evaluated the risk of gout in patients with alcohol-related diseases and alcohol dependence syndrome.
  
  
  METHODS
  We used the Taiwan National Health Insurance Research Database (NHIRD) to conduct a nationwide population-based cohort study to assess the risk of gout and gout incidence in patients with alcohol-related diseases and alcohol dependence syndrome (as defined by the International Classification of Diseases, Ninth Revision). In the NHIRD records from 1998 to 2008, we identified 11,675 cases of alcohol-related diseases. The control group comprised 23,350 cases without alcohol-related diseases propensity score-matched (1 case: 2 controls) for age, age group, and sex.
  
  
  RESULTS
  The results revealed that alcohol-related diseases were significantly associated with gout risk (adjusted hazard ratio 1.88; P<0.0001). Of the alcohol-related disease cases, 34.1% of the patients had alcohol dependence syndrome (males 34.8%; females 32.4%), and alcohol dependence was independently associated with gout occurrence (relative risk [RR] 2.01; P<0.0001). Severe alcohol-dependent patients (who were also the heavy benzodiazepines users), were associated with an increased risk of gout (RR 1.71 to 4.21, P≤0.0182).
  
  
  CONCLUSIONS
  Physicians should be aware of the association between alcohol dependence syndrome and gout occurrence, and alcohol use assessment and measures to prevent alcohol dependence should be implemented in the integrative care for patients with gout.
authors.affiliation: Kaohsiung Medical University, College of Medicine, School of Medicine, Department of Public Health and Environmental Medicine, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan. Electronic address: p915013@kmu.edu.tw.
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tu
authors.affiliation: Kaohsiung Medical University, College of Medicine, School of Medicine, Department of Public Health and Environmental Medicine, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Tung
authors.affiliation: Kaohsiung Medical University Hospital, Departments of Internal Medicine, Division of Rheumatology, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan.
authors.forename: Wen-Chan
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Kaohsiung Medical University Hospital, Department of Orthopedic Surgery, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan.
authors.forename: Gau-Tyan
authors.initials: GT
authors.lastname: Lin
authors.affiliation: China Medical University, Graduate Institute of Clinical Medical Science, Taichung, Taiwan.
authors.forename: Ying-Chin
authors.initials: YC
authors.lastname: Ko
authors.affiliation: Kaohsiung Medical University Hospital, Department of Surgery, Division of Plastic Surgery, 100, Shih-Chuan 1st Road, Kaohsiung, Taiwan. Electronic address: sushin@kmu.edu.tw.
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol dependence syndrome; Alcohol-related diseases; Benzodiazepines; Gout