Background Hyperuricemia is the most important risk factor for gout development. However, not all patients with hyperuricemia develop gout. Meanwhile, patients during gout attack are not necessarily found hyperuricemia.
Objectives To investigate the interaction between serum uric acid (sUA) and other potential metabolic co-morbidities to precipitate gout development (1).
Methods A prospective study was conducted to link baseline metabolic profiles from the MJ Health Screening Center to gout outcomes extracted from Taiwan’s National Health Insurance database (2). A Cox proportional hazard model was used to assess the metabolic risks for incident gout stratified by hyperuricemia (sUA >7mg/dL).
Results During a mean follow-up of 6.45 years (261,500 PYs), 1,189 patients with clinical gout (898 men, 202 women aged >50 years, and 88 women aged ≤50 years) were identified among 40,513 examinees. The multivariate adjusted hazard ratios (HR) of hyperuricemia for gouty arthritis were 5.80 (95% Confidence Interval, 4.93–6.81) in men and 4.37 (3.38–5.66) in women. Hyper-triglyceridemia (triglyceride >150 mg/dL) was found an independent factor with HRs of 1.38 (1.18–1.60) in men with hyperuricemia and 1.40 (1.02–1.92) in those without. General obesity (body mass index >27 kg/m2) was independently associated with gout in older women with HRs of 1.72 (1.15–2.56) in those with hyperuricemia and 2.19 (1.47–3.26) in those without.
Conclusions Gout attack in patients with sUA below the saturation level was suspected due to a synergistic effect between sUA and triglyceride, or an enhanced effect between sUA and obesity to precipitate gout. Further investigation is needed.
Choi HK, Ford ES, Li C, Curhan G. Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2007;57(1):109-15.
Chen JH, Yeh WT, Chuang SY, Wu YY, Pan WH. Gender-specific risk factors for incident gout: a prospective cohort study. Clin Rheumatol. 2012;31:239-45.
Disclosure of Interest None Declared
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