Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Mortality Due to Coronary Heart Disease and Kidney Disease Among Middle-Aged and Elder Men and Women with Gout In the Singapore Chinese Health Study.
Teng1, Gim Gee, Ang2, Li-Wei, Yuan3, Jian-Min, Koh4, Woon-Puay
National University Health System, Singapore, Singapore
Ministry of Health, Singapore, Singapore
Masonic Cancer Center, University of Minnesota, Minneapolis, MN
Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Impact of gout on mortality is underrated despite increasing evidence of gout being an independent mortality risk factor in Caucasian populations. Whether the link is causal or confounded by lifestyle factors or comorbidities remains unclear. Studies in the Asia are warranted due to rapid modernization, population growth and aging. We examined the association between gout and mortality in a prospective cohort of Chinese men and women in Singapore.
The Singapore Chinese Health Study comprised of 63,257 Chinese, ages 4574 years, living in housing estates and enrolled in 199398 by in-person interview of lifestyle, dietary patterns and medical history. At follow up-I (19992004), 52,322 reported if they had a history of physician-diagnosed gout. Mortality in the cohort was identified via record linkage with death registry, through December 2009. Cox regression analyses examined the associations between gout and mortality risk, adjusted for age, body mass index (BMI), gender, dialect, education, alcohol drinking, physical activity, smoking, saturated fat and cholesterol intake, hypertension, coronary heart disease (CHD), stroke and diabetes.
Among 52,322 subjects eligible for the present analysis, 2,117 (4.1%) had a history of physician-diagnosed gout. The mean age at diagnosis of gout was 54.7 (SD 10.0) years. Compared to subjects without a history of gout, subjects with gout were more likely to have diabetes, hypertension, stroke and CHD. People with gout were more educated, had higher BMI, and consumed more alcohol, saturated fat and cholesterol. After a mean follow-up period of 8.1 (SD 1.9) years, there were 6,660 total deaths, of which 33% were cardiovascular deaths. Relative to those without a history of gout, subjects with gout were at increased mortality from all causes [hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.051.31], CHD (HR 1.34, 95%CI 1.071.68) and kidney disease (HR 6.08, 95%CI 3.769.84). Early age at initial diagnosis of gout was associated with higher mortality from all causes as well as CHD. Stroke mortality was also higher in subjects with gout but the increased risk did not reach statistical significance. The risk estimates associated with gout were higher among women compared to men for mortality from all causes, as well as from CHD, stroke and kidney disease.
Gout is moderately associated with total and CHD mortalities, and a strong risk factor for kidney disease mortality among Chinese in Singapore. Patients with gout should be screened and managed for CHD and kidney disease. Further research is needed to investigate if optimizing care for gout, especially for patients with younger age of onset, may improve survival. None.
To cite this abstract, please use the following information:
Teng, Gim Gee, Ang, Li-Wei, Yuan, Jian-Min, Koh, Woon-Puay; Mortality Due to Coronary Heart Disease and Kidney Disease Among Middle-Aged and Elder Men and Women with Gout In the Singapore Chinese Health Study. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1601