Wednesday, 14 Nov 2018

You are here

Not All Hyperuricemia Leads to Gout

Dalbeth and colleagues studied 4 large prospective cohorts and found that rising levels of serum uric acid (SUA) leads to a non-linear increased risk of incident gout, but only half of those with SUA ≥10mg/dL developed clinically evident gout. 

Researchers analyzed four prospective cohorts (Atherosclerosis Risk in Communities Study, Coronary Artery Risk Development in Young Adults Study, and both the Original and Offspring cohorts of the Framingham Heart Study)  to assess the correlation between baseline SUA and the risk of incident gout.

There were 18 889 gout-free participants followed for a mean 11.2  years of follow-up.

The cumulative 15 year incidence of new gout cases varied according to baseline SUA:

  • SUA 6 mg/dL = 1.1% (0.9 to 1.4) 
  • SUA ≥10 mg/dL = 49% (31 to 67)

The adjusted hazard ration for incident gout was:

  • SUA 6.0-6.9 mg/dL - HR 2.7
  • SUA 7.0-7.9 mg/dL  - HR  6.6
  • SUA 8.0-8.9 mg/dL  - HR 15
  • SUA  9.0-9.9 mg/dL - HR 30
  • SUA ≥10 mg/dL - HR  64.

While hyperuricemia plays a significant role in causing gout, there are other factors, over time that along with prolonged hyperuricemia are necessary to lead to gout.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Treat-to-Target Strategy Cuts Mortality in Gout Patients

More intense treatment of gout with a treat-to-target strategy can reduce patients' risk for death, a Spanish researcher told a press conference Monday at the American College of Rheumatology annual meeting here.

TRIPLE Trial Results

Pegloticase has become an excellent option for management of patients with chronic refractory gout, although treatment may be limited by the development of anti-drug antibodies that lead to loss of serum urate (sUA) lowering effect.

Gout and the Social Determinants of Health

During a fascinating gout session on October 21, Hyon Choi presented an important paper (abstract 874) which used data from the Health Professionals Follow-up Study to try to understand the rapid increase in the incidence of gout in recent decades.

Nurse Led Gout Management Highly Effective

UK researchers have shown that nurse-led gout management, using a treat-to-target urate-lowering strategy, is efficacious and cost-effective compared with usual physicain care. The results are published in the recent Lancet edition.

Worldwide, gout management is suboptimal. In the UK only 40% of gout patients receive urate-lowering therapy, and fewer ever achieve a target serum urate (< 6mg/d) concentration.

It's the Genes, Not the Diet that Raises Urate

Researchers from New Zealand find that in contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.