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Uric acid and risk factors in men

 

Clinical bottom line

 


Reference


KC Lin et al. The interaction between uric acid level and other risk factors on the development of gout among asymptomatic men in a prospective study. J Rheumatol 2000 27: 1501-1505.


Study

This study was done in 223 asymptomatic men with hyperuricaemia from the Kinmen islands off southern China. They were originally studied in 1991-2 and reassessed in 1996-7. In one town there were 391 hyperuricaemic men, of whom 36 had gout. Of the remainder asymptomatic men, 223 (65%) were available at follow up.

At baseline demographic information was collected, including details of alcohol consumption, and personal and family history. The presence of gout at reassessment was established clinically be a single rheumatologist based on established clinical symptoms and clinical record review.

Results

The five-year cumulative incidence of gout in men (mean age about 50 years) with hyperuricaemia and initially asymptomatic was 19%. The cumulative incidence increased with increasing baseline serum uric acid (Figure 1), and 61% of men with a serum uric acid of more than 9 mg/dL (530 µmol/L) developed gout over five years.

Figure 1: Five-year cumulative incidence of gout according to baseline serum uric acid

The other factor associated with developing gout was occasional excessive drinking but no regular alcohol use, was the most important factor in the development of gout, even when the concentration of uric acid in serum was below 8 mg/dL. After adjusting for uric acid at baseline, follow up uric acid increase, persistent alcohol consumption, use of diuretics and body mass index increase were independent predictors for gout.

Comment

Men with high serum uric acid levels should not binge drink, or get overweight. The implication that most men with very high serum uric acid levels will develop clinical gout at some time.