Table 1.

Summary of epidemiologic evidence of hyperuricemia or gout with OA.

Reference	Study name	Country	Design	Sample size	Study variable	Site of OA	Definition of OA	Main outcomes	Adjustment
Hyperuricemia
Acheson et al. (10)	New Haven 1960 Census	USA	Cross-sectional	Cases: 685 Control: 1,704	UA	Hand, whole body	Radio-graphic	–UA was associated with hand OA and body site OA among women but not men (univariate analysis). –UA was associated with whole body OA in men but not women (adjusted).	Age, gender, weight/height
Anderson et al. (11)	Health and Nutrition Examination Survey	USA	Cross-sectional	Cases: 315 Control: 4,878	UA	Knee	Clinical and radio-graphic	–UA was associated with increase in risk of knee OA in women (age adjusted OR 1.27; 95% CI 1.15–1.40). –Association was not significant after adjustment of BMI.	Age, BMI, and other variables
Hart et al. (12)	Chingford Study	UK	Cross-sectional	Cases: 118 Control: 861	UA	Knee	Radio-graphic	–UA was not associated with knee OA after adjustment for age and BMI.	Age, BMI
Sun et al. (16)	Ulm Osteoarthritis Study	Germany	Cross-sectional	809	UA	Knee, hip, whole body	Radio-graphic	–Highest tertile of UA was associated with generalized OA in subjects with previous hip arthroplasty for OA (adjusted OR 3.5; 95% CI 1.3–9.1) but not in knee arthroplasty.	Age, gender, BMI, diuretics use, and other variables
Ding et al. (17)	–	China	Cross-sectional	4,685	UA	Knee	Radio-graphic	–Highest tertile of UA was associated with OST in women (adjusted OR 1.43; 95% CI 1.01–2.03). –No association between UA and OST in men. –No association between UA and JSN was observed in both men and women.	Age, BMI, and other factors
Felson et al. (13)	Framingham Heart Study Cohort	USA	Cohort	1,420	UA	Knee	Clinical and radio-graphic	–UA was not associated with knee OA after adjustment of BMI and other factors in both genders.	Age, BMI, physical activity
Bagge et al. (14)	–	Sweden	Cohort	538	UA	Knee	Radio-graphic	–UA was associated with knee OA in women (P < 0.01) but not in men. –Association was not significant after adjustment of BMI.	BMI
Schouten et al. (15)	–	Netherlands	Cohort	142	UA	Knee	Radio-graphic	–Highest tertile of UA was associated with loss of joint space width (OR 1.36; 95% CI 0.46–4.02). –Association was not significant after adjustment for age, gender and BMI.	Age, gender, BMI
Krasnokutsky et al. (18)		USA	Cohort	88	UA	Knee	Clinical and radio-graphic	–UA was associated with JSN. –UA distinguished progressors (JSN > 0.2 mm) and fast progressors (JSN > 0.5 mm) from non-progressors (JSN ≤ 0.0 mm) [AUC 0.63, P = 0.03; and 0.62, P = 0.05, respectively]. –Association was significant after adjustment for age, gender and BMI.	Age, gender, BMI
Gout
Roddy et al. (21)	–	UK	Cross-sectional	Patients: 164 Joint sites: 5,904	Gout	Hand, knee, hip	Previous TKR or clinical	–Site of gout attacks was associated with the presence of OA (adjusted OR 7.94; 95% CI 6.27–10.05). –Associations between acute gout attacks and presence of OA: 1st MTP joint: adjusted OR 2.06; 95% CI 1.28–3.30 Mid-foot: adjusted OR 2.85; 95% CI 1.34–6.03 Knee: adjusted OR 3.07; 95% CI 1.05–8.96 DIP joints: adjusted OR 12.67; 95% CI 1.46–109.9	Age, gender, BMI, diuretics use
Bevis et al. (23)	–	UK	Cross-sectional	Case: 53 Controls: 221	Gout	Hand, knee, foot	Radio-graphic	–No associations were observed between gout and radiographic hand, knee or foot OA. –Gout had odds of having: Nodal hand OA (adjusted OR 1.46; 95% CI 0.61–3.50) Foot OA (adjusted OR 2.16; 95% CI 0.66–7.06) Knee OA (adjusted OR 0.57; 95% CI 0.20–1.65)	BMI, diuretic use, and other factors
Howard et al. (24)	–	USA	Cross-sectional	Gout: 25 UA: 25 Health control: 25	Gout	Knee	Clinical and radio-graphic (ACR criteria)	–68.0% of gout, 52.0% of asymptomatic hyperuricemia, and 28.0% of age-matched control subjects had knee OA (gout vs. control, P = 0.017). –Gout was associated with knee OA (OR 5.46; 95% 1.63, 18.36. P = 0.006). Risk reduced after adjustment with BMI (OR 3.80, 1.60, 13.57. P = 0.040) –HA was not significantly associated with knee OA –Knee OA was more severe in gout patients vs. controls (mean KL grade: 3.50 vs. 2.38, P = 0.001).	BMI
Lally et al. (19)	70-year-old people in Göteborg	USA	Case–control	149	Gout	Hand	Radio-graphic	–17% of gout patients had nodal hand OA. –80% of OA patient had radiographic criteria for gout around the IP joints.	No adjustment
Fam et al. (20)	–	Canada	Case–control	32	Gout	Hand	Physician diagnosis	–In 32 subjects with nodal hand OA, 90% have gouty tophi in the PIP joints and DIP joints.	No adjustment
Roddy et al. (22)	–	UK	Case–control	Cases: 164 Controls: 656	Gout	Hand, Knee, Toe	Self-reported	–Gout was associated with knee pain (adjusted OR 2.05; 95% CI 1.37–3.06), hallux valgus (adjusted OR 2.10; 95% CI 1.39–3.18) and big toe pain (adjusted OR 2.94; 95% CI 1.62–5.34).	BMI, diuretic use
Kuo et al. (26)	–	UK	Case–control	Case: 39,111 Controls: 39,111	Gout	All	Physician diagnosis (database)	–OA diagnosis 10 years prior to incident gout is associated gout (OR 1.27) –Gout was significantly associated with a 1-, 2-, 5-, and 10-year risk of OA (adjusted OR 1.45; 95% CI 1.35–1.54)	Age, gender, BMI, and other factors
Teng et al. (25)	Singapore Chinese Health Study	Singapore	Cohort	51,858	Gout	Knee	Incident TKR (registry)	–Gout was associated with risk of TKR in women (adjusted HR 1.39; 95% CI 1.08–1.79) but not in men (adjusted HR 0.78; 95% CI 0.49–1.23). –Association was stronger in women who were lean (adjusted HR 2.17; 95% CI 1.30–3.64) compared to heavier counterparts (adjusted HR 1.24; 95% CI 0.93–1.66).	Age, gender, BMI, and other factors

USA, United States of American; UK, United Kingdom; UA, uric acid levels; OR, odds ratio; HR, hazard ratio; 95% CI, 95% confidence interval; ACR, American College of Rheumatology; OA, osteoarthritis; TKR, total knee replacement; BMI, body mass index; OST, osteophytes; JSN, joint space narrowing; AUC, area under the receiver operating characteristic curve; IP, interphalangeal; PIP, proximal interphalangeal; DIP, distal interphalangeal; MTP, metatarsophalangeal.