Longitudinal development of incident gout from low-normal baseline serum urate concentrations: individual participant data analysis

BMC Rheumatology

Amanda Phipps-Green¹  Tony R. Merriman²  Tuhina Neogi³  Nicola Dalbeth⁴  Lisa Stamp⁵  Christopher Frampton⁵  William Taylor⁶  Philip C. Robinson⁷ 

[1] Department of Biochemistry, University of Otago, Dunedin, New Zealand;Department of Biochemistry, University of Otago, Dunedin, New Zealand;Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, USA;Department of Medicine, Boston University School of Medicine, Boston, USA;Department of Medicine, University of Auckland, Auckland, New Zealand;Department of Medicine, University of Otago, Christchurch, New Zealand;Department of Medicine, University of Otago, Wellington, New Zealand;University of Queensland Faculty of Medicine, Herston, Herston, Queensland, Australia;Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Herston, Queensland, Australia;

关键词: Gout;    Incidence;    Epidemiology;    Incident;    Urate;    Diagnosis;   

DOI  :  10.1186/s41927-021-00204-4

来源: Springer

【 摘 要 】

IntroductionElevated serum urate (SU) concentration is the central risk factor for the development of gout. The aim of this study was to examine the incidence of gout in people with low and normal SU levels (< 7.00 mg/dL).MethodsLongitudinal cohort data from the Atherosclerosis Risk in Communities Study (ARIC), Coronary Artery Risk Development in Young Adults Study (CARDIA), and both the Original and Offspring cohorts of the Framingham Heart Study (FHS) were used to determine incident gout by baseline SU over 3, 5, 10, 12 and 15 year periods. A Cox proportional hazards model with covariables of age, gender, ethnicity, and cohort was calculated to report the hazard ratios (HR) for incident gout.ResultsThe incidence of gout at 15 years for a baseline SU < 4.00 mg/dL was 0.59%, 4.00–4.49 mg/dL was 1.28%, 4.50–4.99 mg/dL was 0.86%, 5.00–5.49 mg/dL was 0.94%, 5.50–5.99 mg/dL was 1.52%, 6.00–6.49 mg/dL was 2.91%, 6.50–6.99 mg/dL was 3.2%, and > 7.00 mg/dL was 12.2%. In an adjusted Cox proportional hazards model, compared to the referent baseline SU < 4.00 mg/dL, there was a non-significant increase in incident gout for baseline SU bands between 4.00–5.49 mg/dL, whereas incident gout was significantly increased for SU 5.50–5.99 mg/dL (HR 2.60), 6.00–6.49 mg/dL (HR 3.70), 6.50–6.99 mg/dL (HR 5.24) and > 7.00 mg/dL (HR 18.62).ConclusionA baseline SU of 5.50 mg/dL or more is a risk factor for development of gout over 15 years. However, incident gout does occur over time in a small proportion of people with lower baseline SU levels.

【 授权许可】

CC BY