Clinical research study
Comorbidities of Gout and Hyperuricemia in the US General Population: NHANES 2007-2008

https://doi.org/10.1016/j.amjmed.2011.09.033Get rights and content

Abstract

Purpose

The objective of this study was to estimate the latest prevalence of major comorbidities associated with gout and hyperuricemia in the US based on a recent, nationally representative sample of US men and women.

Methods

Using data from 5707 participants aged 20 years and older in the National Health and Nutrition Examination Survey 2007-2008, we calculated the national prevalence and population estimates of major comorbidities according to gout status and various hyperuricemia levels, compared with those without these conditions. Case definitions of gout and comorbidities were based on an affirmative answer to a question that asked whether a physician or a health professional had diagnosed the corresponding condition.

Results

Among these individuals with gout, 74% (6.1 million) had hypertension, 71% (5.5 million) had chronic kidney disease stage ≥2, 53% (4.3 million) were obese, 26% (2.1 million) had diabetes, 24% (2.0 million) had nephrolithiasis, 14% (1.2 million) had myocardial infarction, 11% (0.9 million) had heart failure, and 10% (0.9 million) had suffered a stroke. These proportions were substantially higher than those among individuals without gout (all P-values <.67). With increasing levels of hyperuricemia, there were graded increases in the prevalences of these comorbidities. In the top category (serum urate ≥10 mg/dL), 86% of subjects had chronic kidney disease stage ≥2, 66% had hypertension, 65% were obese, 33% had heart failure, 33% had diabetes, 23% had myocardial infarction, and 12% had stroke. These prevalences were 3-33 times higher than those in the lowest serum urate category (<4 mg/dL). Sex-specific odds ratios tended to be larger among women than men, and the overall comorbidity prevalence was highest among individuals with both gout and hyperuricemia.

Conclusions

These findings from the latest nationally representative data highlight remarkable prevalences and population estimates of comorbidities of gout and hyperuricemia in the US. Appropriate preventive and management measures of these comorbidities should be implemented in gout management, with a preference to strategies that can improve gout and comorbidities together.

Section snippets

Study Population

The NHANES studies are designed to assess the health and nutritional status of adults and children in the US. These studies are based on a representative sample of the noninstitutionalized US civilian population that is selected using a multistage, stratified sampling design. The survey is unique in that it combines interviews, physical examinations, and various laboratory data. After a home interview, participants were invited to attend examination sessions where blood and urine specimens were

Comorbidities of Gout in the US in 2007-2008

In the NHANES 2007-2008, the mean age was 47 years, 48.2% of subjects were male, and 69.4% were white. Overall, 3.9% of US adults reported a physician or health professional diagnosis of gout. Among these individuals with gout, 74% (6.1 million) had hypertension, 71% (5.5 million) had chronic kidney disease stage ≥2, 53% (4.3 million) were obese, 26% (2.1 million) had diabetes, 24% (2.0 million) had nephrolithiasis, 14% (1.2 million) had myocardial infarction, 11% (0.9 million) had heart

Discussion

In this recent, nationally representative sample of US men and women, we found that the prevalence of comorbidities of gout was substantial. Approximately 74% of US adults with gout had hypertension, 71% had chronic kidney disease stage ≥2, 53% were obese, 26% had diabetes, 24% had nephrolithiasis, 14% had a myocardial infarction, and 11% had heart failure. These prevalences were 2-3 times higher than among those without gout. Correspondingly, we found that with increasing levels of

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    Funding: This research was supported by Takeda Pharmaceuticals International, Inc.

    Conflict of Interest: Dr Zhu has nothing to disclose. Dr Pandya is an employee of Takeda Pharmaceuticals International, Inc. Dr Choi has received research funding for other projects from Takeda Pharmaceuticals and has served on advisory boards for Takeda Pharmaceuticals, URL Pharma, and Savient Pharmaceuticals.

    Authorship: All authors had access to the data and a role in writing the manuscript.

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