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Rheumatology (Oxford). 2018 Jan 1;57(1):92-99. doi: 10.1093/rheumatology/kex363.

Decreased incidence of gout in diabetic patients using pioglitazone.

Niu SW1,2,3, Chang KT4, Lin HY1,2,5,6,7,8, Kuo IC1,2, Chang YH9, Chen YH7, Hung CC1, Chiu YW1, Hwang SJ1,3,5.

Author information

1
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
2
Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital.
3
Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
4
Center for Functional Onco-Imaging, Department of Radiological Sciences, University of California, Irvine, CA, USA.
5
Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
6
Department of Physiology and Biophysics.
7
Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA.
8
Center for Lipid Bioscience, Kaohsiung Medical University Hospital.
9
Center of Teaching and Research Kaohsiung, Municipal Hsiaokang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Objective:

The incidence and prevalence of gout are increasing, but the management is poor. Considering the increased prevalence of gout in the diabetic population, this study evaluated the effects of pioglitazone, an insulin resistance inhibitor, on the incidence of gout in the diabetic population.

Methods:

We used data from the National Health Insurance program in Taiwan. The pioglitazone cohort contained 30 100 patients and each patient was age and sex matched with three non-pioglitazone users who were randomly selected from the diabetic population. Cox proportional hazards regression analysis was conducted to estimate the effects of pioglitazone on the incidence of gout in the diabetic population.

Results:

The incidence of gout was significantly lower in pioglitazone users than in non-pioglitazone users [adjusted hazard ratio (aHR) 0.81 (95% CI 0.78, 0.85)]. The HR for the incidence of gout was lower in both male [aHR 0.80 (95% CI 0.75, 0.85)] and female [aHR 0.83 (95% CI 0.78, 0.88)] pioglitazone users than in non-pioglitazone users. An analysis of three age groups (<40, 40-59 and ⩾60 years) revealed that the HRs of both the 40-59 years [aHR 0.78 (95% CI 0.73, 0.83)] and the ⩾60 years [aHR 0.85 (95% CI 0.80, 0.91)] age groups were significantly lower among pioglitazone users than non-pioglitazone users.

Conclusion:

Compared with the non-pioglitazone users, the incidence of gout in the diabetic population using pioglitazone was less.

KEYWORDS:

gout; insulin resistance; non-insulin dependent diabetes mellitus; pioglitazone

PMID:
29040733
DOI:
10.1093/rheumatology/kex363
[Indexed for MEDLINE]

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