Association Between Gout and Comorbidities is Independent of Serum Urate Level

Takeaway

• Cardiovascular comorbidities and chronic kidney disease (CKD) associate with increasing serum urate (SU) in modest (e.g. 1 mg/dl) increments.

• Diabetes mellitus (DM) correlates negatively with SU level.

• The association between gout and cardiovascular comorbidities, DM and hypercholesterolaemia is independent of SU level.

Why this matters

• Prospective cohort studies are warranted to evaluate whether modest increases in SU levels associate with incident comorbidities.

Study design

• A case-control study using data from the UK Biobank.

• Participants with baseline serum urate and without gout were included in the analysis of the association between comorbidities and serum urate (n=458,781).

• Data for 10,265 gout cases and 458,781 control participants were included in the analysis of the association between gout and comorbidities.

• Funding: None.

Key results

• Comorbidities associated with increasing SU level (adjusted OR [aOR] for each 1 mg/dL SU increase):

  • hypercholesterolemia (aOR, 1.10; 95% CI, 1.09-1.11);

  • ischaemic heart disease (aOR, 1.11; 95% CI, 1.09-1.12);

  • hypertension (aOR, 1.29; 95% CI, 1.28-1.30);

  • cardiac failure (aOR, 1.66; 95% CI, 1.52-1.82); and

  • CKD stage 3b or higher (aOR, 3.14; 95% CI, 3.02-3.26).

• DM correlated negatively with SU level (aOR, 0.89; 95% CI, 0.88-0.90).

• After adjusting for covariates including SU, gout associated independently with:

  • ischaemic heart disease (aOR, 1.21; 95% CI, 1.13-1.29);

  • DM (aOR, 1.21; 95% CI, 1.13-1.30);

  • hypercholesterolaemia (aOR, 1.28; 95% CI, 1.22-1.35);

  • hypertension (aOR, 1.75; 95% CI, 1.67-1.83); and

  • cardiac failure (aOR, 4.15; 95% CI, 2.98-5.79).

Limitations

• Gout status was ascertained using self-report and prescription data.

• Recall bias.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Sarfaroj Khan. Association Between Gout and Comorbidities is Independent of Serum Urate Level - Medscape - Jan 04, 2021.