Effects of Gout and CKD on Cardiovascular Risks With Type 2 Diabetes

In a study published in Diabetes, Obesity and Metabolism, Da Young Lee, PhD, and colleagues assessed the effect of gout on cardiovascular disease and mortality risk in individuals with type 2 diabetes and whether chronic kidney disease (CKD) could modify that association.

The study included 757,378 participants from the Korean National Health Insurance Service database, all of whom had type 2 diabetes. Participants were divided into the following groups: CKD⁻Gout⁻, CKD⁻Gout⁺, CKD⁺Gout⁻, and CKD⁺Gout⁺. The researchers used Cox proportional hazard models to determine the risk of myocardial infarction (MI), ischemic stroke, and mortality, after adjustment for cardiometabolic factors.

The median follow-up period was 9.3 years, during which 25,618 participants experienced MI, 38,691 had a stroke, and 78,628 died. The risk of MI or ischemic stroke increased progressively across all groups. The highest adjusted hazard ratio (HR) occurred in the CKD⁺Gout⁺ group (HR, 1.57; 95% CI, 1.46-1.69), followed by the CKD⁺Gout⁻ group (HR, 1.23; 95% CI, 1.20-1.26). The CKD⁺Gout⁺ group had the greatest risks for MI (HR, 1.71), stroke (HR, 1.46), and mortality (HR, 1.78).

Participants in the CKD⁻Gout⁺ group did not demonstrate a significantly increased risk compared with those in the CKD⁻Gout⁻ group. Interaction analyses suggested that the effect of gout on outcomes was more pronounced in patients who had CKD.

Subgroup analyses produced consistent findings across diverse demographic and clinical characteristics.

In conclusion, having CKD with or without gout heightened the risk of cardiovascular disease and mortality. The highest risk occurred in the CKD⁺Gout⁺ group. In addition, the interplay between CKD and gout significantly influenced outcomes.

Source: Diabetes, Obesity and Metabolism