PMID- 30615649
OWN - NLM
STAT- MEDLINE
DCOM- 20190930
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 1
DP  - 2019
TI  - Associations between urate-lowering therapy and the risk of type 2 diabetes 
      mellitus.
PG  - e0210085
LID - 10.1371/journal.pone.0210085 [doi]
LID - e0210085
AB  - BACKGROUND: Gout is independently associated with increased risk of type 2 
      diabetes mellitus (T2DM). Urate-lowering therapy (ULT) might be beneficial in 
      lowering the risks of T2DM. Therefore, we conducted a nested case-control study 
      to evaluate the associations between ULT and T2DM. METHODS: This study retrieved 
      the data of 29,765 gout patients from the period of 1998-2010 by using data from 
      Taiwan's National Health Insurance Research Database. Controls (n = 59,530) were 
      matched at a 1:2 ratio by age, sex, and region. Multivariate Cox proportional 
      hazards regression were performed to examine the dose-dependent relationship 
      between ULT and T2DM. RESULTS: The adjusted Hazard ratio (HR) for the association 
      of T2DM with allopurinol or benzbromarone exposure was 1.17 (95% confidence 
      interval (CI) 1.07-1.28) and1.09 (95% CI 1.03-1.15), respectively. The HR for the 
      cumulative allopurinol dose was 0.87 (95% CI 0.71-1.07) for patients with dose 
      </=1.3 mg/day and was 1.31 (95% CI 1.13-1.52) for those with a dose >15.2 mg/day. 
      Similarly, the HR for the cumulative benzbromarone dose was 0.85(95% CI 
      0.75-0.96) for patients with a dose </=1.3 mg/day and 1.42 (95% CI 1.30-1.55) for 
      patients with a dose>9.4 mg/day, respectively. Moreover, the average exposure 
      dose of >100 mg/day for allopurinol and >100 mg/day for benzbromarone was 
      associated with a 1.28-fold (95% CI 1.11-1.48) and 1.47-fold (95% CI 1.23-1.76) 
      T2DM risk respectively. The HR for patients in aged >50 years group with 
      cumulative dose </=1.3 mg/day of allopurinol or benzbromarone had lower risk of 
      T2DM (HR = 0.74, 95% CI 0.58-0.94 for allopurinol; HR = 0.79, 95% CI 0.69-0.90 
      for benzbromarone). CONCLUSION: Gout patients with prolonged ULT and a high dose 
      of ULT were associated with a significant increase in T2DM risk. Although gout 
      patients with age greater than 50 years and a lower dose of ULT may be beneficial 
      in lowering T2DM risk, further clinical studies need to be confirmed these 
      associations.
FAU - Chang, Hsin-Wen
AU  - Chang HW
AD  - Department of Public Health, China Medical University, Taichung, Taiwan.
AD  - Center for General Education, Hsuan Chuang University, Hsinchu City, Taiwan.
FAU - Lin, Ya-Wen
AU  - Lin YW
AD  - Department of Public Health, China Medical University, Taichung, Taiwan.
AD  - School of Nursing, College of Health Care, China Medical University, Taichung, 
      Taiwan.
FAU - Lin, Ming-Hung
AU  - Lin MH
AD  - Department of Pharmacy, Tajen University, Pingtung, Taiwan.
FAU - Lan, Yu-Ching
AU  - Lan YC
AD  - Department of Health Risk Management, China Medical University, Taichung, Taiwan.
FAU - Wang, Ruey-Yun
AU  - Wang RY
AUID- ORCID: 0000-0002-8262-0873
AD  - Department of Public Health, China Medical University, Taichung, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20190107
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Gout Suppressants)
RN  - 268B43MJ25 (Uric Acid)
RN  - 4POG0RL69O (Benzbromarone)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Allopurinol/administration & dosage
MH  - Benzbromarone/administration & dosage
MH  - Case-Control Studies
MH  - Diabetes Mellitus, Type 2/*epidemiology/etiology/prevention & control
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Gout/blood/complications/*drug therapy
MH  - Gout Suppressants/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prevalence
MH  - Proportional Hazards Models
MH  - Taiwan/epidemiology
MH  - Treatment Outcome
MH  - Uric Acid/blood
MH  - Young Adult
PMC - PMC6322774
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/01/08 06:00
MHDA- 2019/10/01 06:00
PMCR- 2019/01/07
CRDT- 2019/01/08 06:00
PHST- 2018/04/10 00:00 [received]
PHST- 2018/12/17 00:00 [accepted]
PHST- 2019/01/08 06:00 [entrez]
PHST- 2019/01/08 06:00 [pubmed]
PHST- 2019/10/01 06:00 [medline]
PHST- 2019/01/07 00:00 [pmc-release]
AID - PONE-D-18-10702 [pii]
AID - 10.1371/journal.pone.0210085 [doi]
PST - epublish
SO  - PLoS One. 2019 Jan 7;14(1):e0210085. doi: 10.1371/journal.pone.0210085. 
      eCollection 2019.