Table 5.
Chronic Disease as a Risk Factor for gout
| Author year (reference) | Incident/ prevalent gout |
Chronic Disease and hyperuricemia as a risk Factor |
Odds ratio (OR), Risk ratio (RR) or Hazard ratio [95% CI] |
p-value |
|---|---|---|---|---|
|
Hyperuricemia | ||||
| Annemans et al.,2008 (Germany) (9) | prevalent | sUA level > 7–8 vs. sUA<6mg/dl | OR of gout flare 1.65 [1.17–2.33] | <.01 |
| Annemans et al.,2008 (Germany) (9) | prevalent | sUA level > 8–9 vs. sUA<6mg/dl | OR of gout flare 2.37 [1.67–3.36] | <.01 |
| Annemans et al.,2008 (Germany) (9) | prevalent | sUA level from 6–7 vs. sUA<6mg/dl | OR of gout flare 1.37 [91–2.05] | NS |
| Annemans et al.,2008 (Germany) (9) | prevalent | sUA level ≥ 9 vs. sUA<6mg/dl | OR of gout flare 2.48 [1.77–3.49] | <.01 |
| Annemans et al.,2008 (UK study) (9) | prevalent | sUA>8–9 vs. sUA<6mg/dl | OR of gout flare 1.71 [1.04–2.13] | <.01 |
| Annemans et al.,2008 (UK study) (9) | prevalent | sUA level >7–8 vs. sUA<6mg/dl | OR of gout flare 1.49 [1.21–2.42] | <.01 |
| Annemans et al.,2008 (UK study) (9) | prevalent | sUA level from 6–7 vs. sUA<6mg/dl | OR of gout flare 1.33 [.92–1.94] | NS |
| Annemans et al.,2008 (UK study) (9) | prevalent | sUA level ≥ 9 vs. sUA<6mg/dl | OR of any gout 2.15 [1.53–3.01] | <.01 |
| Chang et al., 1997 (13) | prevalent | Hyperuricemia vs. no hyperuricemia | OR of gout flare 8.7 [3.9–19.4] | |
| Kang et al., 2008 (38) | incident | PresurgicalUrate level >9 mg/dl | OR of gout flare 8.25 [2.23–30.54] | 0.002 |
| Kang et al., 2008 (38) | incident | PresurgicalUrate level 6–7 mg/dl | OR ofgout flare 0.56 [0.13–2.46] | 0.441 |
| Kang et al., 2008 (38) | incident | PresurgicalUrate level 7–8 mg/dl | OR of gout flare 1.35 [0.36–5.1] | 0.659 |
| Kang et al., 2008 (38) | incident | PresurgicalUrate level 8–9 mg/dl | OR of gout flare 2.23 [0.64–7.81] | 0.211 |
| Padang et al., 2006 (45) | prevalent | Hyperuricemia (yes vs. no) | OR of gout flare 24.09 [12.65–46.51] | <.0001 |
| Prior et al., 1987 (46) | incident | Serum urate | RR Not specified | <0.05 |
| Wu et al., 2009 (55) | prevalent | Serum urate levels: 6–8.99 mg/dl vs. < 6 mg/dl | OR of recurrent gout flare 2.1 [1.7–2.6] | |
| Lin et al., 2000 (41) | incident | Serum Urate | OR of incident gout, 5.21 [2.91–9.24] | |
| Lin et al., 2000 (41) | incident | Serum Urate change | OR of incident gout, 1.62 [1.23–2.19] | |
| Shoji et al., 2004 (49) | prevalent | Reduction in Serum urate | OR of gout flare, .42 [31-.57] | <.0001 |
|
Hypertension and Heart Disease | ||||
| Bhole et al., 2009 (11) | incident | Hypertension vs. no hypertension | RR for prevalent gout, 1.82 | |
| Brauer et al., 1978 (12) | incident | Hypertension vs. no hypertension | Not specified | <.001 |
| Chang et al., 1997 (13) | prevalent | Hypertension vs. no hypertension | OR of gout flare, 2.2 [1.1–4.3] | |
| Chen et al., 2003 (14) | prevalent | Hypertension vs. no hypertension | Not specified | <.0001 |
| Chen et al., 2007 (15) | incident | Hypertension vs. no hypertension | RR of gout flare 19–44 yrs, 0.99 [0.78–1.27] 45–64 yrs, 1.02 [0.91–1.14] ≥65 yrs, 1.42 [1.23–1.65] |
>0.05 >0.05 >0.05 |
| Choi et al., 2005 (16) | incident | Hypertension vs. no hypertension | RR of incident gout, 2.31 [1.96–2.72] | |
| Janssens et al., 2006 (37) | incident | Hypertension vs. no hypertension | IRR of incident gout, 2.6 [1.2–5.6] | |
| Hochberg et al., 1995 (35) | incident | Incident hypertension (yes vs. no) | RR of incident gout, 3.78,[2.18–6.58] | |
| Hochberg et al., 1995 (35) | incident | Systolic blood pressure mm Hg | RR of new gout flare 1.96 [1.14–3.38] | |
| Roubenoff et al., 1991(47) | incident | Hypertension vs. no hypertension | RR of incident gout, 3.26 | .002 |
| Tikly et al., 1998 (53) | incident | Hypertension vs. no hypertension | OR for incident gout, 3.3 [1.7–6.3] | |
| Mijiyawa et al., 2000 (44) | prevalent | Hypertension vs. no hypertension | Not specified | |
| Janssens et al., 2006 (37) | incident | heart failure vs. no heart failure | IRR of new gout flare 20.9 [2.5–173.8] | |
| Janssens et al., 2006 (37) | incident | Myocardial infarction (yes vs. no) | IRR of new gout flare 1.9 [0.7–4.7] | |
| Anagnostopoulos et al., 2010 (7) | prevalent | Hypertension vs. no hypertension | OR of prevalent gout 2.78 [.65–4.7] | <.01 |
|
Obesity and Body mass index | ||||
| Chen et al.,2007 (15) | prevalent | Overweight vs. not overweight | RR of gout flare: 19–44 years, 1.7 [1.52–1.92] 45–64 years, 1.17 [1.08–1.27] ≥65 years, 1.36 [1.16–1.58] |
|
| Choi et al., 2005 (16) | incident | BMI in various categories vs. BMI 21–22.9 | RR of incident gout 23–24.9, 1.65 [1.27–2.13] 25–29.9, 1.95 [1.44–2.65] 30 to 34.9, 2.33 [1.62–3.36] ≥35, 2.97 [1.73–5.10] |
<.001 |
| Chang et al., 1997 (13) | prevalent | Obesity vs. no obesity | OR of gout flare, 0.7 [0.3–1.8] | |
| Chen et al., 2003 (14) | prevalent | Obesity vs. no obesity | Not specified | <.0001 |
| Choi et al., 2005 (16) | incident | ≥30 lbs weight gain after age 21 vs. range of −4 to 4 lb weight change | RR of incident gout1.99 [1.49–2.66] | <.001 |
| Choi et al., 2005 (16) | incident | 10 lbs weight loss since baseline vs. range of −4 to 4 lb weight change | RR of incident gout, 0.61 [.40-.92] | <.001 |
| Bhole et al., 2009 (11) | incident | Obesity(BMI≥30) vs. no obesity | RR for incident gout 2.74 | |
| Brauer et al., 1978 (12) | incident | BMI vs. normal BMI | Not specified | <.001 |
| Lin et al., 2000 (41) | incident | Obesity vs. no obesity | 2.86 [1.29–6.45] | |
| Lin et al., 2000 (41) | incident | Baseline BMI | OR of incident gout, 1.01 [0.72–1.22] | |
| Lin et al., 2000 (41) | incident | BMI change during follow up | OR of incident gout, 1.51 [1.12–2.19] | |
| Mijiyawa et al., 2000 (44) | prevalent | Overweight/obesity vs. no obesity | Not specified | |
| Tikly et al., 1998 (53) | incident | Obesity | OR for incident gout, 5.3 [2.6–11.2] | <.05 |
| Roubenoff et al., 1991 (47) | incident | Excessive weight gain ≥2.7 kg | RR of incident gout, 2.07 | .02 |
|
Diabetes | ||||
| Chen et al., 2007 (15) | Incident | Type 2 diabetes vs. none | RR of gout flare 19–44 yrs, 0.99 [0.78–1.27] 45–64 yrs, 1.02 [0.91–1.14] ≥65 yrs, 2.09 [1.52–2.88] |
|
| Chen et al., 2003 (14) | Prevalent | Type 2 diabetes mellitus (yes vs. no) | Not specified | 0.52 |
| Suppiah et al., 2008 (52) | prevalent | Type 2 Diabetes vs. no diabetes | OR of prevalent gout, 4.4; [2.1–9.6] | |
| Anagnostopoulos et al., 2010 (7) | Prevalent | Diabetes Mellitus vs. no diabetes | OR of prevalent gout 2.63 [1.35–5.14] | <.01 |
|
Renal disease including renal insufficiency | ||||
| Chen et al., 2003 (14) | Prevalent | Renal calculi vs. no renal calculi | Not specified | <.0001 |
| Chen et al., 2003 (14) | Prevalent | Renal insufficiency (yes vs. no) | Not specified | 0.68 |
| Chang et al., 1997 (13) | Prevalent | Creatinine ≥2 mg/dl vs. <2 | OR of gout flare 2.9[.9–9.4] | |
| Suppiah et al., 2008 (52) | prevalent | Impaired renal function (yes vs. no) | OR of prevalent gout, 1.2 [1.1–1.4] | |
| Li-Yu et al., 200 (42) | Prevalent | Serum creatinine levels | Not specified | |
| Andracco et al., 2009 (8) | Prevalent | Renal stones vs. no renal stones | OR for acute gout, 13.3 [1.1–158.3] | .064 |
| Padang et al., 2006 (45) | Prevalent | Nephrolithiasis (yes vs. no) | OR of gout flare 3.45 [.43–8.56] | < .005 |
|
Hyperlipidemia | ||||
| Chen et al.,2007 (15) | prevalent | Hypertriglyceridemia vs. none | RR of gout flare: 19–44 years, 2.18 [1.72, 2.75] 45–64 years, 1.59 [1.33–1.89] ≥65 years, 4.51 [2.70–7.53] |
|
| Chen et al., 2003 (14) | Prevalent | Hypercholesterolemia (yes vs. no) | Not specified | 0.0003 |
| Chang et al., 1997 (13) | Prevalent | Hypertriglyceridemia (yes vs. no) | OR of gout flare 1.9 [1.0–3.7] | |
| Chang et al., 1997 (13) | Prevalent | Hypercholesterolemia (yes vs. no) | OR of gout flare 1.5 [.6–3.6] | |
| Chen et al., 2003 (14) | prevalent | Hypercholesterolemia (yes vs. no) | RR of gout flare: 19–44 years, 1.73 [1.29–2.32] 45–64 years, 1.44 [1.19–1.74] ≥65 years, 1.17 [.90–1.53] |
|
| Chen et al., 2003 (14) | Prevalent | Hypertriglyceridemia (yes vs. no) | Not specified | <.0001 |
| Prior et al., 1987 (46) | incident | Hypercholesterolemia (yes vs. no) | RR Not specified | <0.05 |
| Suppiah et al., 2008 (52) | prevalent | Hypertriglyceridemia (yes vs. no) | OR of prevalent gout, 2.2 [1.0–4.7] | p<.05 |
| Padang et al., 2006 (45) | Prevalent | Hypertriglyceridemia (yes vs. no) | OR of gout flare 70.4 [34.89–144.25] | <.0001 |
|
Menopause, Hormone Use and Cancer | ||||
| Hak et al., 2008 (33) | incident | natural and surgical menopause vs. premenopausal patients | Serum urate higher by .36 [.14 to .57] | |
| Hak et al., 2010 (34) | incident | Menopause at <45yrs vs. 50–54 yrs | RR of incident gout, 1.62 [1.12–2.33] | |