Association Between Gout and Comorbidities is Independent of Serum Urate Level

Sarfaroj Khan 

Disclosures

January 04, 2021

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.

Sandoval-Plata G, Nakafero G, Chakravorty M, Morgan K, Abhishek A. Association between serum urate, gout and comorbidities: a case-control study using data from the UK Biobank. Rheumatology (Oxford). 2020 Dec 13 [Epub ahead of print]. doi: 10.1093/rheumatology/keaa773. PMID: 33313843 View abstract

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

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