Modifiable risk factors for gout confirmed in meta-analysis
medwireNews: Obesity, hypertension, and diuretic use are all independently associated with a doubling in the risk for gout, results of a systematic review and meta-analysis suggest.
“Patients with these risk factors should be recognised by clinicians as being at greater risk of developing gout and provided with appropriate management and treatment options,” say James Prior (Keele University, UK) and study co-authors, noting that “all three [risk factors] are common and can be modified.”
The researchers included 11 cohort studies investigating the relationship between these risk factors and the development of gout in their meta-analysis. They found that individuals with obesity (BMI≥30 kg/m2) were significantly more likely to develop gout than nonobese participants, with a pooled multivariate-adjusted relative risk (RR) of 2.24.
“Previous research has demonstrated the benefits of weight reduction interventions in preventing gout,” and this finding adds “further evidence to the need to tackle obesity due to its strong association with gout,” write the study authors in Arthritis Research & Therapy.
Moreover, people with hypertension were significantly more likely to have incident gout than normotensive individuals (pooled adjusted RR=2.11), as were those taking versus not taking diuretics (pooled adjusted RR=2.39).
These results suggest that “careful selection of [antihypertensive] agents can help to reduce the risk of future gout,” and that, where possible, “diuretics should be avoided in those at risk of developing gout,” say Prior and team.
The authors note that the risk estimates included in the meta-analysis were all adjusted for the other factors of interest, and are therefore “confident [that] these risk estimates are independent.”
They caution, however, that there was statistically significant heterogeneity among studies investigating hypertension or diuretic use as risk factors for gout.
And the study authors conclude: “As diuretic use in hypertensive patients is likely and a large proportion of such patients will be overweight, future research should consist of prospective studies which consider the interaction between co-morbidities and examine how certain clusters of co-morbidities influence the risk of developing gout.”
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