Gout and CKD Synergy Sharply Elevates Cardiovascular Risks and Mortality in Diabetes Patients: Study Reveals
South Korea: A recent study published in Diabetes, Obesity and Metabolism has revealed the detrimental interplay between gout and chronic kidney disease (CKD) in individuals with type 2 diabetes, significantly elevating the risks of myocardial infarction (MI), stroke, and mortality. While gout alone did not increase these risks substantially, its coexistence with CKD was markedly amplified.
"Compared to individuals without gout or CKD, those with both conditions exhibited a 71% higher risk of MI, a 46% greater risk of stroke, and a 78% increased risk of death," the researchers reported.
Nan Hee Kim, Korea University Ansan Hospital, Ansan, Republic of Korea, and colleagues aimed to investigate the influence of gout on cardiovascular disease and mortality risks in patients with type 2 diabetes and assess the role of chronic kidney disease as a potential modifier of this relationship.
For this purpose, the researchers utilized the Korean National Health Insurance Service database to analyze data from 757,378 individuals with type 2 diabetes. Participants were categorized into four groups: CKD−Gout−, CKD−Gout+, CKD+Gout−, and CKD+Gout+. To evaluate the risks of myocardial infarction, ischemic stroke, and mortality, Cox proportional hazard models were employed, adjusting for cardiometabolic factors to ensure robust findings.
The study led to the following findings:
- Over a median follow-up of 9.3 years, 25,618 individuals experienced myocardial infarction (MI), 38,691 experienced stroke, and 78,628 deaths were recorded.
- The risk of MI and stroke progressively increased across the groups, with the highest adjusted hazard ratio (HR) observed in the CKD+Gout+ group (HR: 1.57), followed by the CKD+Gout− group (HR: 1.23).
- The CKD+Gout+ group demonstrated the greatest risks for MI (HR: 1.71), stroke (HR: 1.46), and mortality (HR: 1.78).
- Individuals with gout alone did not show a significant increase in risk compared to those without gout or CKD.
- Interaction analyses revealed that the impact of gout on outcomes was more pronounced in patients with CKD.
- Subgroup analyses confirmed consistent findings across various demographic and clinical characteristics.
The findings revealed that CKD, whether accompanied by gout or not, elevated the risk of cardiovascular disease and mortality, with the highest risk identified in the CKD+Gout+ group. The interplay between CKD and gout had a significant impact on these outcomes.
"Our results emphasize the importance of early detection and comprehensive management strategies for patients with diabetes, CKD, and gout. Given the heightened risks associated with the CKD+Gout+ combination, clinicians are encouraged to adopt a proactive approach to mitigate cardiovascular complications and improve patient survival," the researchers concluded.
Reference: https://doi.org/10.1111/dom.16165
