Sleep Apnoea and the Risk of Gout

Sarfaroj Khan 

May 01, 2020

Takeaway

  • The risk of gout was almost double in patients with obstructive sleep apnoea (OSA); however, this association disappeared after adjustment for body mass index (BMI), renal function, heart failure, and recent use of diuretics.

Why this matters

  • Elevated uric acid has been observed not only in gout but also in patients with OSA. 

  • Physicians should be more aware that gout occurs more frequently in the presence of various comorbidities, including OSA.

Study design

  • This case-control study included 111,509 participants with gout (cases) and 210,241 matched participants without gout (controls) using the UK Clinical Practice Research Datalink GOLD.

  • Conditional logistic regression was used to estimate the risk of gout related to a diagnosis of OSA.

  • Funding: None.

Key results

  • Patients with OSA were at an increased risk of gout (OR, 1.86; 95% CI, 1.71-2.02).

  • However, the effect disappeared after adjustment for smoking status, BMI, alcohol use, a history of heart failure, diabetes mellitus, renal function, recent use of diuretics, and other medications (OR, 1.05; 95% CI, 0.96-1.16).

  • Patients with OSA and a high BMI remained at an increased risk of gout vs those without OSA (BMI: 30-34 kg/m2, adjusted OR [aOR], 1.34; 95% CI, 1.13-1.59; BMI: ≥35 kg/m2, aOR, 1.56; 95% CI, 1.33-1.83)

  • Compared to patients without OSA, those with OSA and a history of heart failure had an increased risk of gout (aOR, 1.82; 95% CI, 1.21-2.73).

  • Women vs men with OSA were at a higher risk of gout (aOR, 1.64; 95% CI, 1.19-2.27).

Limitations

  • Possibility of underreporting of OSA and gout, particularly in the less severe cases.

  • Risk of residual confounding.

This clinical summary first appeared on Univadis from Medscape.

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