Article Text
Abstract
Objectives To evaluate whether gout is associated with a higher risk of hearing loss in older adults.
Design Retrospective cohort study.
Setting USA.
Participants 5% random sample of US Medicare claims 2006–2012, representative of US adults aged 65 years or older.
Primary and secondary outcomes Incident (new) hearing loss identified by the presence of at least two claims at least 4 weeks apart with an International Classification of Diseases, Ninth Revision, 389.xx, with no respective claim in the baseline 1-year observation period.
Results Among the 1.71 million eligible people, 89 409 developed incident hearing impairment. The crude incidence rates of incident hearing impairment in people with versus without gout were 16.9 vs. 8.7 per 1000 person-years. Using Cox regression analyses adjusted for demographics, medical comorbidity and common cardiovascular and gout medications, we found that gout was associated with a significantly higher HR of incident hearing impairment, HR was 1.44 (95% CI 1.40 to 1.49, p<0.0001). Findings were confirmed in sensitivity analyses that substituted continuous Charlson-Romano Index with categorical variable or all comorbidities and additionally cardiovascular risk factors, with minimal attenuation of HR.
Conclusions Gout is associated with a higher risk of development of hearing loss in older adults. Future studies need to assess the underlying mechanisms of this association.
- epidemiology
- rheumatology
- audiology
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Footnotes
Contributors JAS designed the study, developed study protocol, reviewed analyses and wrote the first draft of the paper. JDC performed the data abstraction and data analyses. All authors made revisions to the manuscript, read and approved the final manuscript.
Funding This material is the result of work supported by research funds from the Division of Rheumatology at the UAB and the resources and use of facilities at the Birmingham VA Medical Center, Birmingham, Alabama, USA.
Disclaimer The funding body did not play any role in design, collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.
Competing interests JAS has received research grants from Takeda and Savient and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Fidia, Crealta/Horizon and Allergan pharmaceuticals, WebMD, UBM LLC, National Institute of Health and the American College of Rheumatology. JAS serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA, Inc., a 501 (c)(3) entity. JAS is a member of the executive of OMERACT, an organisation that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology’s (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor, Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. JAS is the editor and Director of the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis. JDC has no relevant financial conflicts.
Patient consent Not required.
Ethics approval The University of Alabama at Birmingham’s Institutional Review Board approved this study, and all investigations were conducted in conformity with ethical principles of research.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement These data can be obtained from the Centers for Medicare and Medicaid Services (CMS) Chronic Condition Data Warehouse. Data requests can be made to the following email address: (datauseagreement@cms.hhs.gov). The DUA agreement with CMS does not allow us to share these data due to the inclusion of PHI and PII data and the rules of use of Medicare data. We are ready to share the data with colleagues, after obtaining appropriate permissions from CMS Chronic Condition Data Warehouse and the University of Alabama at Birmingham Ethics Committee, related to HIPAA and Privacy policies. Additional information about these data can be found at https://www.resdac.org/resconnect/articles/148