scholarly journals Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shuichi Ito ◽  
Tomoko Torii ◽  
Akihiro Nakajima ◽  
Takeshi Iijima ◽  
Hiroshi Murano ◽  
...  
Keyword(s):  
Uric Acid ◽  
Health Insurance ◽  
Pediatric Population ◽  
Gouty Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Insurance Claims ◽  
Cross Sectional ◽  
Total Prevalence ◽  
Health Insurance Claims

Abstract Background Although gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population. Methods This cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration. Results Total prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year. Conclusions Even the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population. Trial registration UMIN000036029.

scholarly journals Urate-lowering therapy for gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masataka Honda ◽  
Hideki Horiuchi ◽  
Tomoko Torii ◽  
Akihiro Nakajima ◽  
Takeshi Iijima ◽  
...  
Keyword(s):  
Uric Acid ◽  
Health Insurance ◽  
Kidney Disease ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lowering Therapy ◽  
Adult Dose

Abstract Background Our previous research showed that uric acid lowering therapy (ULT) for gout and hyperuricemia is being prescribed for pediatric patients even though these drugs have not been approved for use in children. However, the actual clinical situation has not been clearly elucidated. In this paper, we provide an in-depth look at the details of actual clinical practice. Methods This retrospective cross-sectional study accessed health insurance data for 696,277 children from April 2016 through March 2017 to identify pediatric patients with gout or asymptomatic hyperuricemia, calculate the proportion of patients prescribed ULTs, and analyze population characteristics. Adherence and mean dose for febuxostat and allopurinol, the most commonly prescribed drugs, were also analyzed. Results Among children with gout or asymptomatic hyperuricemia, we found that 35.1% (97/276) were prescribed ULT. This proportion increased with age, especially among males. By comorbidity, ULT was prescribed to 47.9% (46/96) of patients with kidney disease, 41.3% (26/63) for cardiovascular disease, 40.0% (6/15) for Down syndrome, and 27.1% (32/118) for metabolic syndrome. In patients with kidney disease, febuxostat was prescribed more than twice as frequently as allopurinol (28 vs. 12). Median values for the medication possession ratio (MPR) of febuxostat and allopurinol were 70.1 and 76.7%, respectively, and prescriptions were continued for a relatively long period for both drugs. Both drugs were prescribed at about half the adult dose for patients 6–11 years old and about the same as the adult dose for patients 12–18 years old. Conclusions This study showed that the continuous management of serum uric acid is being explored using off-label use of ULT in pediatric patients with gout or asymptomatic hyperuricemia in Japan. Drug selection is based on patient characteristics such as sex, age, and comorbidities, and pediatric dosage is based on usage experience in adults. To develop appropriate pediatric ULT, clinical trials are needed on the efficacy and safety of ULT in the pediatric population. Trial registration UMIN000036029.

Prevalence of type 2 diabetes by age, sex and geographical area among two million public assistance recipients in Japan: a cross-sectional study using a nationally representative claims database

2021 ◽  
pp. jech-2020-216158
Author(s):  
Tami Sengoku ◽  
Tatsuro Ishizaki ◽  
Yoshihito Goto ◽  
Tomohide Iwao ◽  
Shosuke Ohtera ◽  
...  
Keyword(s):  
Health Insurance ◽  
Regional Differences ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Insurance Claims ◽  
The City ◽  
Crude Prevalence ◽  
Age And Sex

BackgroundRecognising the importance of the social determinants of health, the Japanese government introduced a health management support programme targeted at type 2 diabetes (T2D) for public assistance recipients (PAR) in 2018. However, evidence of the T2D prevalence among PAR is lacking. We aimed to estimate T2D prevalence by age and sex among PAR, compared with the prevalence among health insurance enrollees (HIE). Additionally, regional differences in T2D prevalence among PAR were examined.MethodsThis was a cross-sectional study using 1-month health insurance claims of both PAR and HIE. The Fact-finding Survey data on Medical Assistance and the National Database of Health Insurance Claims data were used. T2D prevalence among PAR and HIE were assessed by age and sex, respectively. Moreover, to examine regional differences in T2D prevalence of inpatients and outpatients among PAR, T2D crude prevalence and age-standardised prevalence were calculated by prefecture. Multilevel logistic regression analysis was also conducted at the city level.ResultsT2D crude prevalence was 7.7% in PAR (inpatients and outpatients). Among outpatients, the prevalence was 7.5% in PAR and 4.1% in HIE, respectively. The mean crude prevalence and age-standardised prevalence of T2D (inpatients and outpatients) among 47 prefectures were 7.8% and 3.9%, respectively. In the city-level analysis, the OR for the prevalence of T2D by region ranged from 0.31 to 1.51.ConclusionThe prevalence of T2D among PAR was higher than HIE and there were regional differences in the prevalence of PAR. Measures to prevent the progression of diabetes among PAR by region are needed.

scholarly journals Association between the course of hypnotics treatment for insomnia and work functioning impairment in Japanese workers

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243635
Author(s):  
Makoto Okawara ◽  
Tomohisa Nagata ◽  
Masako Nagata ◽  
Makoto Otani ◽  
Koji Mori ◽  
...  
Keyword(s):  
Health Insurance ◽  
Treatment Duration ◽  
Cross Sectional Study ◽  
Work Functioning ◽  
Insurance Claims ◽  
Cross Sectional ◽  
Healthcare Data ◽  
Japanese Workers ◽  
Increased Risk ◽  
Health Insurance Claims

Study objectives This cross-sectional study analyzed the effect of treatment with hypnotics for sleep disorders, particularly insomnia, on daytime work functioning by phase of treatment in Japanese workers. Methods Subjects were respondents (n = 36,375) to a questionnaire survey conducted in 2015 to assess work functioning impairment in 15 companies in Japan. The questionnaire results were analyzed together with the respondents’ healthcare data extracted from public health insurance claims. Work functioning impairment was measured using the Work Functioning Impairment Scale (WFun). The status of treatment for insomnia was determined using data on diseases and prescribed drugs extracted from health insurance claims from the past 16 months. The odds ratio of severe work functioning impairment according to on-treatment duration and off-treatment duration was estimated using logistic regression analysis. Results The risk of severe work functioning impairment was significantly higher in subjects with insomnia who were being treated with hypnotics for 1 month or longer compared to non-insomnia subjects. This increased risk tended to be reduced with longer on-treatment duration. For subjects who had previously received hypnotics treatment for insomnia, the risk of severe work functioning impairment was significantly increased in all subgroups stratified by time from discontinuation of the prescription. This increased risk tended to be reduced with longer off-treatment duration. Conclusions Workers who are or were receiving hypnotics to treat insomnia may have a higher risk of daytime functioning impairment. Those with protracted insomnia require careful assessment of the risks and benefits of prescription hypnotics.

scholarly journals KEBIASAAN MAKAN MAKANAN TINGGI PURIN DENGAN KADAR ASAM URAT DI PUSKESMAS

2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Veronica Flaurensia Magdalena Kussoy ◽  
Rina Kundre ◽  
Ferdinand Wowiling
Keyword(s):  
Uric Acid ◽  
Eating Habits ◽  
Gouty Arthritis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significance Level ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Fisher’S Exact Test

Abstract: Unhealthy community eating patterns by consuming high protein foods that contain high purine levels causes the incidence of hyperuricemia to increase. Consuming high purine foods will increase uric acid levels in the blood, which predisposes to gouty arthritis. The aim was to determine the Corelation between high purine food eating habits with uric acid levels in the working area of Remboken Community Health Center. The research design used descriptive analytic with Cross Sectional Study approach. A sample of 51 respondents was obtained using the Total Sampling technique. The results of statistical test studies using the Fisher’s Exact Test at a significance level of 95%, obtained a significant value ρ = 0.034 <α (0.05). The conclusion is that there is a relationship between eating habits of high purine foods with uric acid levels.Keywords : Purines, Gout, Eating habitsAbstrak : Pola makan masyarakat yang tidak sehat dengan mengkonsumsi makanan berprotein tinggi yang mengandung kadar purin tinggi menyebabkan kejadian hiperurisemia semakin meningkat. Mengkonsumsi makanan tinggi purin akan meningkatkan kadar asam urat dalam darah, yang merupakan predisposisi terjadinya gout arthritis. Tujuan untuk mengetahui hubungan kebiasaan makan makanan tinggi purin dengan kadar asam urat di wilayah kerja puskesmas remboken. Desain penelitian yang digunakan yaitu Deskriptif Analitik dengan pendekatan Cross Sectional Study. Sampel berjumlah 51 responden yang didapat dengan menggunakan tehnik Total Sampling. Hasil penelitian uji statistik menggunakan uji Fisher’s Exact Test pada tingkat kemaknaan 95%, didapatkan nilai signifikan ρ = 0,034 < α (0,05). Kesimpulan ada hubungan antara kebiasaan makan makanan tinggi purin dengan kadar asam urat.Kata kunci : Purin, Asam Urat, Kebiasaan makan

scholarly journals Serum uric acid control for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan

2021 ◽  
pp. annrheumdis-2021-220439
Author(s):  
Ruriko Koto ◽  
Akihiro Nakajima ◽  
Hideki Horiuchi ◽  
Hisashi Yamanaka
Keyword(s):  
Uric Acid ◽  
Cohort Study ◽  
Health Insurance ◽  
Serum Uric Acid ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Disease Status ◽  
Insurance Claims ◽  
Health Insurance Claims ◽  
Gout Flare

ObjectivesIn patients with gout, treating to target serum uric acid levels (sUA) of ≤6.0 mg/dL is universally recommended to prevent gout flare. However, there is no consensus on asymptomatic hyperuricaemia. Using Japanese health insurance claims data, we explored potential benefits of sUA control for preventing gout flare in subjects with asymptomatic hyperuricaemia.MethodsThis retrospective cohort study analysed the JMDC Claims Database from April 2012 through June 2019. Subjects with sUA ≥8.0 mg/dL were identified, and disease status (prescriptions for urate-lowering therapy (ULT), occurrence of gout flare, sUA) was investigated for 1 year. Time to first onset and incidence rate of gout flare were determined by disease status subgroups for 2 years or more. The relationship between gout flare and sUA control was assessed using multivariable analysis.ResultsThe analysis population was 19 261 subjects who met eligibility criteria. We found fewer occurrences of gout flare, for both gout and asymptomatic hyperuricaemia, in patients who achieved sUA ≤6.0 mg/dL with ULT than in patients whose sUA remained >6.0 mg/dL or who were not receiving ULT. In particular, analysis by a Cox proportional-hazard model for time to first gout flare indicated that the HR was lowest, at 0.45 (95% CI 0.27 to 0.76), in subjects with asymptomatic hyperuricaemia on ULT (5.0<sUA ≤ 6.0 mg/dL), compared with untreated subjects (sUA ≥8.0 mg/dL).ConclusionsOccurrences of gout flare were reduced by controlling sUA at ≤6.0 mg/dL in subjects with asymptomatic hyperuricaemia as well as in those with gout.Trial registration numberUMIN000039985.

scholarly journals Cross-sectional study to compare the biochemical parameters in low normal versus high normal plasma glucose levels in euglycemic individuals

2020 ◽  
Vol 7 (6) ◽  
pp. 997
Author(s):  
Dharmendra Jhavar ◽  
Neha Kirti ◽  
Sumit Kumar Vishwakarma ◽  
Umesh Kumar Chandra ◽  
Vinod Verma
Keyword(s):  
Uric Acid ◽  
Total Cholesterol ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Normal Group ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Mean ◽  
The Difference

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.

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