According to a sizable prospective study, excessive body fat and genetic susceptibility are both linked to an increased chance of developing gout, especially in US women.
The study discovered that the risk is greatest when both factors are present.
For instance, past cross-sectional studies have discovered that obesity, a significant modifiable risk factor for gout, is more significantly related with female than male gout. According to the study, genetics also play a significant role in gout, with estimates of serum urate heritability ranging from 25 to 60 percent.
“The global burden of gout and comorbidity has increased in recent decades, disproportionately so among women,” wrote authors led by Hyon Choi, MD, director, clinical epidemiology, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston. “Yet, traditionally considered a disease of men, data on female-specific gout are scare, despite purported differences from males in risk factors and clinical spectrums.”
When comparing the risks for men from the Health Professionals Follow-Up Study to those for women participating in the Nurses’ Health Study (NHS) I and II, Choi and colleagues looked into the potential contributions of obesity and genetics to the development of gout (HPFS).
The relationship between individuals’ body mass index (BMI) and genetic risk score (GRS) was also discovered by researchers.
The analysis comprised 10 888 (mean age, 54.3 years) males from the HPFS, 18 244 (mean age, 47 years) women from the NHS I, and 8246 (mean age, 37.4 years) women from the NHS II. In NHS I, there were 1360 incident gout cases, and in NHS II, there were 188 cases, during the course of a follow-up period totaling over a million person-years.
According to the study, the prevalence of obesity at the time of gout diagnosis in the 2 female cohorts was 41% and 57%, respectively. In a multivariate analysis that controlled for variables like age, blood pressure, menopausal status, and nutrition, researchers discovered that higher levels of adiposity and higher GRS were independently positively and substantially linked with the likelihood of incident gout.
According to researchers, among women, greater BMI alone accounted for 42% of the combined effect, higher GRS alone for 37%, and an additive interaction between the two for 22%. In the case of men, BMI alone accounted for 44% of the joint effect, GRS alone for 42%, and an additive interaction between the two for 14%.
“From a public health standpoint, our findings reinforce adiposity as a major target for reducing the incidence and burden of female gout, with its higher frequencies of coronary heart disease, type 2 diabetes, and other cardiometabolic-renal comorbidities than male gout, particularly for women born with a greater genetic predisposition to developing this disease,” noted Choi and colleagues.
Despite accounting for covariates, researchers pointed out that, as with any observational study, these results could still be affected by residual and unmeasured confounding.
According to researchers, addressing excess body fat may help avoid many cases of gout in women and its cardiometabolic comorbidities, with the effect possibly being larger in genetically susceptible women.