The association of gout with an increased risk of hypertension and diabetes mellitus among stroke survivors in New Zealand: A cross-sectional study using routinely collected electronic health data

Association between Gout, Urate-Lowering Therapy, and Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study

Gout is the most prevalent inflammatory arthritis in adults. Although the link between gout and type 2 diabetes mellitus (T2DM) has been documented, our understanding of the association between urate-lowering therapy (ULT) among gout patients and T2DM development remains poor. We included 69,326 patients with new-onset gout in 2000-2011. Each case was matched randomly with 1 patient without gout during the study period, and 69,326 patients were recognized as the comparison cohort. A Cox proportional hazard regression model was used to analyze differences in the risk of T2DM development between patients with and without gout after considering related comorbidities. After adjusting for potential confounders, the case group had a higher risk of T2DM than the control cohort (adjusted hazard ratio (aHR) = 1.30, 95%confidence interval (CI) = 1.24-1.38; P < 0.001). Gout patients without appropriate ULT had significantly higher risk of T2DM development than the control cohort (aHR = 1.39; 95%CI = 1.30-1.48; P < 0.001). Among gout patients, those receiving ULT excluding probenecid (aHR = 0.80; 95%CI = 0.64-1.00), all had significantly lower risk of T2DM than gout patients without ULT (all aHR < 0.90; all P < 0.001). In this study, we found that gout increased the risk of T2DM; however, patients with any ULT exhibited a lower risk of T2DM than gout patients without any ULT (all aHR < 0.90, P < 0.001; excluding probenecid).

Relationship between Uric Acid Level and Severity of Acute Primary Cerebral Infarction: A Cross-Sectional Study

Numerous studies have shown that uric acid (UA) is associated with cerebrovascular disease, but whether UA is a protective factor or worsens the risk of developing cerebrovascular disease remains controversial. This study investigated the relationship between UA levels detected at admission and the severity of acute primary cerebral infarction. This cross-sectional study enrolled patients with acute primary cerebral infarction (N = 238, 157 men). We designated the levels of serum UA measured at the time of admission as the independent variable and the degree of neurological impairment at admission as the dependent variable. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the extent of neurological dysfunction: NIHSS ≤ 5, minor stroke; NIHSS > 5, moderate to severe stroke. There was a statistically significant difference in UA levels between patients with mild cerebral infarctions (NIHSS ≤ 5) and those with moderate or severe cerebral infarctions (NIHSS > 5) (P < 0.0001). After adjusting for confounding factors, the serum UA level was found to be nonlinearly related to NIHSS, and the inflection point was 372 μmol/L. The extent of the influence and confidence interval was 0.99 (0.98, 0.99) on the left side of the inflection point and 1.00 (1.00, 1.01) on the right side. There was a nonlinear relationship between the UA level measured on admission and the degree of neurological impairment in patients with acute primary cerebral infarction. When UA was <372 μmol/L, it was negatively correlated with the degree of neurological impairment in patients with acute cerebral infarction, but when UA was ≥372 μmol/L, the protective effect of UA disappeared.