The Association of Gout With Sleep Disorders
The Association of Gout With Sleep Disorders
Within the CiPCA database, 1689 people were identified as having consulted their GP for gout between 2001 and 2008. Cases were successfully matched to controls (n = 6756) in a 1:4 ratio, as described above. Cases were well-matched to controls in terms of the matching variables (Table 1). The prevalence of hypertension, IHD and type II diabetes mellitus was higher among gout cases than controls, as was the prescription of diuretic medications.
Overall, 3.7% (n = 316) of those studied had at least one Read coded consultation for a sleep disorder, of which 10.1% (n = 32) had a Read code for sleep apnoea. The proportion of people with any sleep disorder was higher in the gout cases (4.9%) than in the controls (3.5%) (1.4% difference, 95% CI: 0.3%, 2.5%) (Table 2). There was no effect of clustering by general practice. Hence, single level logistic regression models, adjusted for practice, were used for all analyses. After adjustment for potentially confounding comorbidities and diuretic prescriptions, participants continued to have 1.4 times the odds of gout if they had a sleep disorder than if they did not (OR 1.39; 95% CI 1.06, 1.81).
There was a 1.4-fold increased odds of gout in those with a sleep disorder but no record of sleep apnoea (OR 1.36; 95% CI 1.03, 1.80). After adjustment for potential confounders, this association remained significant (OR1.37; 95% CI 1.03, 1.82). Sleep apnoea was also coded in a higher proportion of gout cases than controls (0.7% of cases and 0.3% of controls). This amounted to a two-fold increased odds of gout in those with sleep apnoea than in those without (OR 2.1; 95% CI 1.01, 4.39). However, after adjustment for potentially confounding comorbidities and medication prescriptions, this increase in odds was attenuated 1.49 (95% CI 0.70, 3.14).
Results
Case and Control Selection
Within the CiPCA database, 1689 people were identified as having consulted their GP for gout between 2001 and 2008. Cases were successfully matched to controls (n = 6756) in a 1:4 ratio, as described above. Cases were well-matched to controls in terms of the matching variables (Table 1). The prevalence of hypertension, IHD and type II diabetes mellitus was higher among gout cases than controls, as was the prescription of diuretic medications.
Association Between Gout and Sleep Disorders
Overall, 3.7% (n = 316) of those studied had at least one Read coded consultation for a sleep disorder, of which 10.1% (n = 32) had a Read code for sleep apnoea. The proportion of people with any sleep disorder was higher in the gout cases (4.9%) than in the controls (3.5%) (1.4% difference, 95% CI: 0.3%, 2.5%) (Table 2). There was no effect of clustering by general practice. Hence, single level logistic regression models, adjusted for practice, were used for all analyses. After adjustment for potentially confounding comorbidities and diuretic prescriptions, participants continued to have 1.4 times the odds of gout if they had a sleep disorder than if they did not (OR 1.39; 95% CI 1.06, 1.81).
There was a 1.4-fold increased odds of gout in those with a sleep disorder but no record of sleep apnoea (OR 1.36; 95% CI 1.03, 1.80). After adjustment for potential confounders, this association remained significant (OR1.37; 95% CI 1.03, 1.82). Sleep apnoea was also coded in a higher proportion of gout cases than controls (0.7% of cases and 0.3% of controls). This amounted to a two-fold increased odds of gout in those with sleep apnoea than in those without (OR 2.1; 95% CI 1.01, 4.39). However, after adjustment for potentially confounding comorbidities and medication prescriptions, this increase in odds was attenuated 1.49 (95% CI 0.70, 3.14).
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