PHILADELPHIA — Women's risk factors for developing gout are similar to those in men, and baseline serum levels of uric acid may be the most powerful predictor, findings from the Framingham Heart Study show.
Women with no clinical indication of gout but a serum uric acid level of 8.0 mg/dL or greater at baseline had a subsequent 2.7% rate of gout during an average 28 years of follow-up—a 46-fold higher rate than women with a serum uric acid level of less than 5 mg/dL at baseline, Dr. Vidula Bhole said at the annual meeting of the American College of Rheumatology.
Serum uric acid likewise posed a powerful risk in men. Those with a level of 8 mg/dL or more at baseline had a 3.3% incidence rate during follow-up, 61-fold higher than men who entered the study with a serum level below 5.0 mg/dL.
Even a baseline uric acid level of 5-5.9 mg/dL conferred a greater than threefold higher risk for developing gout in women and a greater than fourfold higher risk in men, compared with those whose level was under 5 mg/dL, said Dr. Bhole, an epidemiologist in the Arthritis Research Centre of Canada at the University of British Columbia in Vancouver. (See table.)
Dr. Bhole and her associates used prospectively collected data from the more than 5,000 residents of Framingham, Mass., who entered the Heart Study in 1948, at a baseline age of 29-62 years. Among the enrollees, 4,427 had no history of gout at entry and formed the focus for the new analysis.
The group included 2,476 women, with an average age of 47 years and an average serum uric acid level of 4.0 mg/dL. The group also included 1,967 men who entered at an average age of 46 years and a mean serum uric acid level of 5.1 mg/dL.
Average body mass index was 25 kg/m
The subjects developed 304 cases of gout during an average 28 years of follow-up, with an incidence rate of 1.4 cases/1,000 person-years of follow-up in the women and 4.0 cases/1,000 person years follow-up in the men.
An analysis of gout incidence rates relative to baseline serum uric acid showed that, for any baseline level, women developed less gout than men. For example, among people who entered the study with a serum level of 7.0-7.9 mg/dL, the subsequent incidence was 1.3% in women and 1.8% in men.
A multivariate analysis identified several baseline factors linked to a significantly higher rate of incident gout in both genders: age, obesity, heavy alcohol use, hypertension, and diuretic use.
Dr. Bhole said she had no relevant financial relationships. Two of her study colleagues received grant support from and served as consultants to Takeda. One of Dr. Bhole's associates also serves on the advisory board for Savient, a company developing a uric acid–lowering drug.
Age, obesity, and heavy alcohol and diuretic use were linked to a higher rate of incident gout in both genders.
Source DR. BHOLE
Elsevier Global Medical News