The risk of gout among patients with sleep apnea: a matched cohort study

Abstract

Objective
Obstructive sleep apnea (OSA) is associated with a range of serious comorbidities. This study investigates whether people with OSA are more likely to develop gout than those without OSA in both short and long term.

Methods A matched retrospective cohort study was undertaken in the UK Clinical Practice Research Datalink. Individuals aged =18 years with an incident diagnosis of OSA between 1990 and 2010 were identified and matched on age, gender and practice to up to four individuals without OSA; follow-up was until end of 2015. Hazard ratios (HR) were estimated using Cox regression adjusted for general health, lifestyle and comorbid characteristics. Risk of incident gout was assessed at different time points and BMI category specific results presented.

Results Study sample included 15,879 patients with OSA and 63,296 without; median follow-up was 5.8 years. 4.9% OSA and 2.6% non-OSA patients developed gout. Incidence rate per 1000 person-years was 7.83 (95%CI 7.29, 8.40) and 4.03 (3.84, 4.23) among those with and without OSA respectively; adjusted HR 1.42 (1.29, 1.56). The risk of incident gout among OSA patients compared to those without was highest one to two years after index date (1.64 (1.30, 2.06)). This finding persisted among those overweight and obese. For those with normal BMI the highest significant HR 2.02 (1.13, 3.62) was observed at two to five years post index date.

Conclusions People with OSA continued to be at higher risk of developing gout beyond the first year after OSA diagnosis. Peak incidence of gout varies according to BMI.