Urate Levels Predict Long-Term Gout Risk

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In a large Swedish study of middle-aged individuals, increments in baseline serum urate levels were associated with progressively increased risks of gout over a mean 28 years of follow-up.
In a large Swedish study of middle-aged individuals, increments in baseline serum urate levels were associated with progressively increased risks of gout over a mean 28 years of follow-up.

Individuals' risk of clinically diagnosed gout over an average of 28 years varies by baseline serum urate (SU) levels, with increasing levels associated with progressively greater risk, investigators concluded.

Meliha C. Kapetanovic, MD, PhD, of Lund University and Skåne University Hospital in Lund, Sweden, and colleagues studied 33,346 asymptomatic middle-aged participants (mean age 45.7 years at inclusion) in the Malmö Preventive Project, a population-based screening program for cardiovascular risk factors, alcohol abuse, and breast cancer in Malmö, Sweden. The study population was screened from 1974 to 1992.

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During a mean follow-up of 28.2 years, new cases of gout developed in 1275 participants: 261 women (2.4%) and 1014 men (3.8%), the investigators reported in Arthritis Research & Therapy (2018;20:190). At baseline, 164 women (1.5%) and 2191 men (9.8%) had hyperuricemia (HU, SU level above 405 µmol/L).  

Among women and men, gout risk increased along with serum SU. Baseline serum SU levels (in µmol/L) of 360 or less, 361–405, and greater than 405 were associated with a 1.9%, 7.6%, and 17.7% increased risk of gout, respectively, among women, and a 2.7%, 6.8%, and 13.3% increased risk among men.

Compared with an SU level below 360, levels of 361–405 and greater than 405 were associated with a significant 4.4- and 13.1-fold increased risk of new gout cases, respectively, among women and a significant 2.7- and 6.4-fold increased risk, respectively, among men, in age-adjusted analyses.

“Asymptomatic HU is common among healthy middle-aged individuals and is associated with an increased risk for incident gout in both sexes,” Dr Kapetanovic's group concluded. “In contrast to previous studies the risk to develop clinical gout at comparable SU values was found to be higher in women than in men.”

Reference

Kapetanovic MC, Nilsson P, Turesson C, et al. The risk of clinically diagnosed gout by serum urate levels: results from 30 years follow-up of the Malmö Preventive Project cohort in Southern Sweden. Arthritis Res Ther. 2018;20:190.

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