All About Gout: 8 Key Findings

Heart disease risk goes up with gout. In patients with obstructive coronary artery disease, worse outcomes were linked with a history of gout, even though levels of optimal baseline cardiovascular disease medical therapy were high. The findings suggest that standard medical therapy does not address residual cardiovascular risk. Further study is suggested to determine whether targeted anti‐inflammatory therapy or better control of gout can improve cardiovascular outcomes.

Obesity raises the odds of developing gout. Overall obesity may be a risk factor for gout and is associated with higher serum urate concentrations. Each standard deviation (about 4.6 kg/m²) increase in genetically predicted BMI was associated with an odds ratio of gout of 2.24 and a 0.30 mg/dL increase in serum urate concentrations. Abdominal obesity (as measured by waist-to-hip ratio adjusted for BMI) was not linked with gout risk.

More gout with sleep apnea. Gout is more likely to develop in persons who have obstructive sleep apnea (OSA) than in those who do not. In a recent study, gout developed in 4.9% of patients with OSA and 2.6% of those without. The incidence rate per 1000 person‐years was 7.83 and 4.03 among those with and without OSA, respectively. The risk of incident gout among patients who had OSA was highest 1 to 2 years after index date. The finding persisted among those who were overweight or obese.

Gout may protect against colorectal cancer. Colonoscopy-documented colorectal cancer may occur less frequently in patients who have gout than in those who have osteoarthritis. The 10-year prevalence of colorectal cancer was significantly lower with gout (0.8%) than with osteoarthritis (3.7%) in a population of veterans. Differences in colorectal cancer rates remained significant after stratifying for NSAID use. The findings suggest gout may have a protective effect against colorectal cancer.

Urate levels predict long-term gout risk. Researchers explored the long-term risk of incident gout among asymptomatic adults who had various serum urate levels. The absolute risk of clinically diagnosed gout over 30 years in middle-aged persons-3.8%-increased progressively in men and women in relation to baseline serum urate level. The increase was significantly higher in women; the associations between baseline risk markers and serum urate levels were similar in both sexes.

Gout drug diminishes adverse events. The FREED study examined whether lowering uric acid levels with febuxostat prevents cerebral, cardiovascular, and renal events and death in patients aged 65 years and older with hyperuricemia. The primary end point, a composite of these events, occurred in 23% of patients in the febuxostat group and 29% of those in the non-febuxostat group. The findings suggest that lowering uric acid levels with febuxostat provides clinical benefit.

Gout linked to increased risk of erectile dysfunction. Researchers identified 2290 new cases of ED among 38,438 patients with gout and 8447 cases among 154,332 persons in the comparison cohort over a 5-year median follow-up (11.9 vs 10.5 per 1000 person-years, respectively). Univariate and multivariate hazard ratios for ED among patients with gout were 1.13 and 1.15, respectively. The findings support a possible role for hyperuricemia and inflammation as independent risk factors for ED.