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. 2019 Jul 8;78(10):1430–1437. doi: 10.1136/annrheumdis-2019-215521

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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Two steps in the development of gout. We performed, for the first time, a GWAS using clinically defined gout cases and AHUA controls to identify gout loci that influence the progression from hyperuricaemia to gout (the second step). Previous GWASs on gout were performed with gout cases and normouricaemics of which both SUA elevation (the first step) and the second step consisted; however, most of their identified loci were associated with the first step. Because only a proportion of AHUA individuals are known to develop gout, we hypothesised that the genetic effects at the second step would play important roles in crystal-induced inflammation as gout attack. AHUA, asymptomatic hyperuricaemia; GWAS, genome-wide association study; SUA, serum uric acid.