Allopurinol use and type 2 diabetes incidence among patients with gout: A VA retrospective cohort study

摘要

To assess the impact of allopurinol on diabetes in a retrospective cohort of Veterans’ Affairs patients with gout. The New York Harbor VA computerized patient record system was searched to identify patients with an ICD-9 code for gout meeting at least 4 modified 1977 American Rheumatology Association gout diagnostic criteria. Patients were divided into subgroups based on 30 continuous days of allopurinol , versus no allopurinol . New diagnoses of diabetes , defined according to American Diabetes Association diagnostic criteria or clinical documentation explicitly stating a new diagnosis of diabetes , were identified during an observation period from January 1, 2000 through December 31, 2015. Six hundred six gout patients used allopurinol 30 continuous days, and 478 patients never used allopurinol . Over an average 7.9 ± 4.8 years of follow-up, there was no significant difference in diabetes incidence between the allopurinol and non- allopurinol groups (11.7/1000 person-years vs 10.0/1000 person-years, P = .27). A lower diabetes incidence in the longest versus shortest quartiles of allopurinol use (6.3 per 1000 person-years vs 19.4 per 1000 person-years, P .0001) was attributable to longer duration of medical follow-up. In this study, allopurinol use was not associated with decreased diabetes incidence. Prospective studies may further elucidate the relationship between hyperuricemia, gout, xanthine oxidase activity, and diabetes , and the potential impact of gout treatments on diabetes incidence.