Background few data are available on the association between thyroid dysfunction and gout and the available evidence were limited by small case number and insufficient confounder control. Earlier studies found high prevalence of hypothyroidism among gout patients. Erickson et al. reported 25% of female and 12% of male gout patients had hypothyroidism and these rates were 2.5 and 6 times greater in male and female controls. The association between hyperthyroidism is rarely reported, despite evidence linking hyperthyroidism and hyperuricaemia.
Objectives The aim of this study was to estimate the risk of hyperuricaemia and gout in people in either hypothyroid or hyperthyroid status.
Methods This survey analyzed data from participants who underwent health screening programsat Chang Gung Memorial Hospital, in northern Taiwan (2000-20010). Participants were classified as euthyroid, hypothyroid and hyperthyroid status according to thyroid-stimulating hormone (TSH) levels. Logistic regression models were used to calculate ORs for hyperuricaemia or gout comparing participants with thyroid dysfunction with euthyroid ones.
Results From 2000 to 2010, a total of 87813 people were enrolled in our study. Baseline characteristics were shown in Table 1. Overall, the number of male participants (48753, 55.5%) were slightly more than female participants (39060, 44.5%). However, people with hypothyroid or hyperthyroid status were marked female-predominant. Among hypothyroid participants, BMI was slightly higher than euthyroid participant, however, the percentage of obesity was similar. In contrast, BMI was lower among hyperthyroid participants. More hypothyroid, but not hyperthyroid, participants were hypertensive than euthyroid participants.
The prevalence of gout among hypothyroid and hyperthroid participant was significantly higher than euthyroid participants in both genders (p<0.001, both). Mean serum uric levels were higher among hypothyroid and hyperthyroid than euthyroid women (p<0.001, both); however, SUA levels were not significantly different by thyroid status among male participant. Similarly, hyperuricaemia prevalence was more frequent among hypothyroid and hyperthyroid female, but not male, participants.
Hypothyroid and hyperthyroid status were associated with age and sex-adjusted ORs (95% CI) of 1.20 (1.05–1.37; p=0.007) and 1.18 (1.07–1.29; p=0.001) for hyperuricaemia. Further adjusted by low eGFR, azotemia and metabolic syndrome, hypothyroid and hyperthyroid status were associated with multivariate ORs (95% CI) of 1.05 (0.91–1.21, p=0.496) and 1.14 (1.03–1.25, p=0.012) for hyperuricaemia.
Adjusted by age and sex, hypothyroid and hyperthyroid status were associated with odds ratios (95% CI) of 1.72 (1.37–2.15) and 1.52 (1.28–1.79) for gout. Further adjusted by low eGFR, azotemia and metabolic syndrome, hypothyroid and hyperthyroid status were associated with multivariate ORs (95% CI) of 1.47 (1.17–1.85, p<0.001) and 1.48 (1.25–1.75, p<0.001) for gout. Even after further adjusted by hyperuricaemia, hypothyroid and hyperthyroid status were still associated with gout, with ORs (95% CI) of 1.45 (1.15–1.84; p=0.002) and 1.47 (1.23–1.75; p<0.001), respectively.
Conclusions Thyroid dysfunction were significantly associated with gout and, weakly with hyperuriaemia. Thyroid dysfunction may predispose to gout in a manner other than hyperuricaemia.
Disclosure of Interest None Declared
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