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Gout risk and obesity

Study
Results
Comment

We know that weight is involved in gout, because serum uric acid levels are increased in people with higher BMI, and can fall when weight is lost. A large US study [1] gives us some real figures about weight and risks of gout.

Study

This was a prospective study of a large number of male health professionals aged 40-75 years at the start in 1986. Prospective follow up over 12 years included considerable numbers of assessments of anthropomorphic variables, of diet, health outcomes, and medical conditions. Gout diagnosis was determined every two years, and specific questionnaires ensured that diagnosis was according to standard criteria.

Results

The 47,000 men without gout initially formed the cohort, with 730 confirmed new cases of gout (1.6%) over the 12 years of study. Gout incidence was significantly related to initial BMI (Figure 1), as well as BMI at age 21 years, and initial waist to hip ratio. Men who had gained weight by more than 12 kg since age 21 had a significantly increased risk of gout (by about twice). Men who had lost more than 6 kg since the start of the study had a significantly reduced risk of gout (by about 40%).



Figure 1: Gout incidence over 12 years, and relationship to initial BMI





After adjusting for age, weight, and diuretic use, hypertension increased the risk of gout by two to three times. After adjusting for age, weight, and hypertension diagnosis, diuretic use increased the risk of gout by two to three times.

Comment

This is an important contribution to the information we have about obesity and gout, mainly because it is large and prospective. It confirms what we know, that increased weight is associated with gout. Most gout cases are attributable to excess weight, especially where the BMI is over 25. It also confirms that losing weight reduces the risk of developing gout. Weight loss reduces uric acid. This is yet another reason why it is not a good idea to be fat.

Reference:

  1. HK Choi et al. Obesity, weight change, hypertension, diuretic use, and risk of gout in men. Archives of Internal Medicine 2005 165: 742-748.

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