Ab0104 Approach to the Association of Gout and Diabetes and Its Repercussions on Morbidity Using a Nationwide Dataset of Hospitalizations

Background: Gout and diabetes mellitus (DM) are two highly prevalent diseases worldwide, closely related by pathophysiology. The implications of people with gout also presenting DM have received little attention in the literature, especially in terms of morbidity development. Objectives: To analyze the impact of associating DM with gout in a nationwide hospitalized population in Spain. Methods: We analyzed the Minimal Basic Data Set from 192,062 Spanish hospitalizations with gout (ICD-9 coding) from 2005 to 2015. The comorbidities of interest were cerebrovascular diseases, venous thromboembolism, sepsis, chronic kidney disease, arrhythmia, dementia, liver disease, obstructive pulmonary disease, and other rheumatic diseases, among others. Firstly, the prevalence of DM in the entire population was estimated, later stratified by type of DM (type 1 DM, type 2 DM, and other types of DM), as well as complicated or not complicated, according to suitable ICD-9 codes, estimating their 95% confidence intervals (CI). We built a multiple logistic regression model to discern the characteristics of gouty patients with or without DM. Secondly, patients with repeated admissions in the dataset were identified and matched by age, sex, kidney disease, cardiovascular disease (combined from heart, cerebral, and peripheral disease), and infections (from pneumonia, urinary infections, and sepsis) at the first tertile (2005-2008). Later, we compared the frequencies of comorbidities of interest in the second (2009-2012) and third tertiles (2012-2015) by the chi-2 test. Results: In the gout dataset, the prevalence of DM was 27.7% (95% CI 27.5-27.9%). By subtypes, type 2 DM was far more prevalent (27.4%, 95%CI 27.2-27.6%) than type 1 (0.1%, 95%CI 0.1-0.2%) or other forms of DM (0.4%, 95%CI 0.3-0.4%). The presence of complicated DM was 19.8% (95%CI 19.4-20.1%) over all DM patients. The Figure 1 shows the results of multiple logistic regression. Variables that most classified gouty people with DM were dyslipidemia, obesity, female sex, older ages, as well as heart and renal diseases. On the other hand, venous thromboembolism and other concurrent rheumatic diseases were linked to those without DM. The Table 1 shows the comorbidities distribution in patients with recurrent admission, finding increased numbers of ~10% for cardiovascular events (driven by coronary disease and heart failure) and kidney disease in those with DM, similar for infections and less presence of venous thromboembolism. Conclusion: An analysis of 11 years of hospitalizations for gout confirms a different comorbidity profile between DM and non-DM, with a close relationship to metabolic syndrome. Assessing readmissions, the co-presence of DM had a significant impact on the cardiovascular and renal profile of the patient with gout, identifying no impact on infections and less risk of thromboembolism. Our findings may be interesting when treating a gout and DM patient. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: Mariano Andrés Menarini, Grunenthal, Patricia Mora: None declared, Fernando Borrás: None declared, Eugenio De Miguel: None declared.