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The association of obesity with the development of gout has been attributed to hyperuricaemia.1 ,2 However, in patients with poorly controlled gout, weight loss leads to profound suppression of gout flares, despite a relatively small reduction in urate concentrations.3 Monosodium urate (MSU) crystals are frequently identified in asymptomatic, uninflamed joints in patients with gout,4 suggesting that local or systemic factors regulate the inflammatory response to intra-articular crystals. Since weight loss is associated with reduced chronic inflammation,5 we hypothesised that weight loss influences the presentation of gout through regulation of inflammatory responses to MSU crystals.
Twenty patients with morbid obesity (body mass index ≥35 kg/m2) and type 2 diabetes, with no history of gout, were prospectively recruited from two public hospitals in Auckland, New Zealand. The Northern X Ethics Committee approved the study and all patients provided …
Contributors ND (the guarantor) accepts full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish. ND conceived of the study, contributed to the data interpretation and drafted the manuscript. BP did the experimental work. SY recruited participants and coordinated study visits. JC and RM conceived of the study, contributed to the data interpretation and drafted the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the Auckland Medical Research Foundation (grant number 1109014). Shelley Yip was the recipient of the Jens Henrik Jensen academic fellowship administered by the University of Auckland.
Competing interests None.
Patient consent Obtained.
Ethics approval Northern X Regional Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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