title: Association Between Gout and Incident Type 2 Diabetes Mellitus: A Retrospective Cohort Study.
abstract: OBJECTIVE
  We investigated the association between gout and the risk of type 2 diabetes mellitus.
  
  
  METHODS
  Population-based representative insurance (outpatient and inpatient) claims data of 29,765 patients with gout and 59,530 controls without gout (1:2 case:control ratio) between 1998 and 2010 in Taiwan were identified. The association between gout and type 2 diabetes was evaluated using the Cox proportional hazards model. Moreover, the combined effects of sex and incident gout on the risk of type 2 diabetes were estimated.
  
  
  RESULTS
  In total, 3940 patients (13.24%) with gout and 6334 controls (10.64%) developed type 2 diabetes in the follow-up period. Multivariate analyses revealed a significant association between gout and type 2 diabetes. Compared with the control group, the adjusted hazard ratios (95% confidence intervals) for type 2 diabetes were 1.62 (1.54-1.70) in men, 1.97 (1.81-2.14) in women, and 1.70 (1.62-1.77) overall. The multiplicative interaction was β = 0.18 and P = .0001, suggesting a positive interaction between sex and incident gout. Moreover, compared with men without gout, a significantly higher risk of type 2 diabetes was noted in women without gout (adjusted relative risk [95% confidence interval], 1.17 [1.10-1.24]), men with gout (1.11 [1.06-1.16]), and women with gout (1.47 [1.37-1.57]) (P for interaction = .0058).
  
  
  CONCLUSIONS
  Gout is a strong and independent risk factor for type 2 diabetes, and female patients with gout are at a higher risk of type 2 diabetes than are male patients with gout.
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Tung
authors.affiliation: Division of Plastic Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Taiwan; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan.
authors.forename: Su-Shin
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Wen-Chan
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Taiwan.
authors.forename: Gau-Tyan
authors.initials: GT
authors.lastname: Lin
authors.affiliation: Center for General Education, Hsuan Chuang University, Hsinchu, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Hsin-Wen
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; PhD Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Taiwan. Electronic address: p915013@kmu.edu.tw.
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Gout; Retrospective cohort study; Sex; Type 2 diabetes