COMMENTARY

The Link Between Sleep Apnea and Gout

Kevin Deane, MD, PhD

Disclosures

February 25, 2016

Sleep Apnea and the Risk of Incident Gout: A Population-Based, Body Mass Index-Matched Cohort Study

Zhang Y, Peloquin CE, Dubreuil M, et al
Arthritis Rheumatol. 2015;67:3298-3302

Article Summary

Using a large data set from the United Kingdom, Zhang and colleagues found that sleep apnea was independently associated with incident cases of articular gout. They found this association after identifying 270 cases of incident gout among a group of 9865 individuals with newly diagnosed sleep apnea and 43,598 matched individuals without sleep apnea. Specifically, the raw rate of incident gout in individuals with sleep apnea was 8.4 cases per 1000 person-years compared with 4.8 cases per 1000 person-years in individuals without sleep apnea.

In addition, the investigators adjusted the analyses for other risk factors that may be related to gout and sleep apnea, including age, gender, body mass index, alcohol intake, and hypertension. In these adjusted analyses, the rate of incident gout was still significantly higher among individuals with sleep apnea compared with individuals without sleep apnea.

Viewpoint

Of particular interest in this study is the finding that sleep apnea was associated with gout even after adjustment for other variables (eg, body mass index, hypertension) that are known risk factors for gout. As the authors mention, this strongly suggests that there may be a specific link between cardiopulmonary physiology and hyperuricemia, and this finding fits nicely with studies that have already found associations between pulmonary hypertension and hyperuricemia.[1]

Although more data are needed, one wonders whether individuals who present with incident gout should also be evaluated for sleep apnea. We look forward to additional studies in this area that can help elucidate the mechanisms of this association, as well as lead to clinical approaches to improve management of patients with these conditions.

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