Kristin S Biggerstaff1,2,3, Donna L White1,4,5,6, Benjamin J Frankfort3, Peter Richardson1,4, Silvia Orengo-Nania2,3, Jose Garcia7, Elizabeth Y Chiao1,8, Jennifer R Kramer9,10. 1. Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. 2. Eye Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. 3. Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA. 4. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 5. Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA. 6. Center for Translational Research in Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center, Houston, TX, USA. 7. Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, University of Washington, Seattle, WA, USA. 8. Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. 9. Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. jkramer@bcm.edu. 10. Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. jkramer@bcm.edu.
Abstract
PURPOSE: A history of gout, arthritis due to hyperuricemia, has been associated with decreased risk for neurodegenerative diseases such as Parkinson's disease. We performed a population-based case-control study in the US Department of Veterans Affairs (VA) medical centers nationwide to assess if gout or hyperuricemia is similarly associated with the ocular neurodegenerative condition glaucoma. METHODS: We used ICD-9 codes to identify a nationwide cohort of patients examined at VA healthcare eye clinics between 2000 and 2015 with a diagnosis of open-angle glaucoma (OAG) or of glaucoma suspect. We used incidence density matching to choose controls. We used multivariable logistic regression to examine associations between a history of gout and uric acid (UA) levels on relative risk of OAG or glaucoma suspect. RESULTS: There were 1,144,428 OAG or glaucoma suspect cases and 1,144,428 matched controls. Veterans with a history of gout had a small significant decreased risk of OAG compared to controls (ORadjusted(adj) = 0.985, 95% CI: 0.974-0.996). Treated gout was similarly associated with small decreased risk (ORadj = 0.963, 95% CI: 0.950-0.976). A small subset of patients (11.9% of cases and 13.2% of controls) had UA labs available; veterans with the highest median UA levels (> 7.29 mg/dL) did not have statistically significant differences in relative OAG risk (ORadj = 1.014, 95% CI: 0.991-1.036). CONCLUSION: Prospective research in other cohorts is needed to confirm our findings in veterans suggesting a history of gout is associated with a small decreased relative risk of glaucoma.
PURPOSE: A history of gout, arthritis due to hyperuricemia, has been associated with decreased risk for neurodegenerative diseases such as Parkinson's disease. We performed a population-based case-control study in the US Department of Veterans Affairs (VA) medical centers nationwide to assess if gout or hyperuricemia is similarly associated with the ocular neurodegenerative condition glaucoma. METHODS: We used ICD-9 codes to identify a nationwide cohort of patients examined at VA healthcare eye clinics between 2000 and 2015 with a diagnosis of open-angle glaucoma (OAG) or of glaucoma suspect. We used incidence density matching to choose controls. We used multivariable logistic regression to examine associations between a history of gout and uric acid (UA) levels on relative risk of OAG or glaucoma suspect. RESULTS: There were 1,144,428 OAG or glaucoma suspect cases and 1,144,428 matched controls. Veterans with a history of gout had a small significant decreased risk of OAG compared to controls (ORadjusted(adj) = 0.985, 95% CI: 0.974-0.996). Treated gout was similarly associated with small decreased risk (ORadj = 0.963, 95% CI: 0.950-0.976). A small subset of patients (11.9% of cases and 13.2% of controls) had UA labs available; veterans with the highest median UA levels (> 7.29 mg/dL) did not have statistically significant differences in relative OAG risk (ORadj = 1.014, 95% CI: 0.991-1.036). CONCLUSION: Prospective research in other cohorts is needed to confirm our findings in veterans suggesting a history of gout is associated with a small decreased relative risk of glaucoma.
Authors: Ahmed Mousa; Altaf A Kondkar; Saleh A Al-Obeidan; Taif A Azad; Tahira Sultan; Essam Osman; Khaled K Abu-Amero Journal: Saudi Med J Date: 2015-06 Impact factor: 1.484