In a study published in Arthritis & Rheumatology that included nearly 1.3 million men ages 20 to 39 who participated in three serial health checks at two-year intervals, men with metabolic syndrome (MetS) and those who developed MetS, especially those with elevated triglyceride MetS components and abdominal obesity had higher risks of developing gout.
Among participants, 18,473 developed gout, and those with MetS across all controls had nearly four times the risk than participants without MetS. The development of MetS more than doubled the risk of gout incidents, while the recovery of MetS reduced the risk of gout incidents by almost half.
"This is the first large-scale study to explore the association between dynamic changes in MetS and the risk of gout," said co-corresponding author Jaejoon Lee, MD, PhD of Sungkyunkwan University School of Medicine, South Korea. . “Prevention and recovery from MetS can significantly reduce the risk of gout in young adults.”
Goals
Little data is available on whether changes in metabolic syndrome (MetS) affect incident gout. We investigated associations between MetS changes and incident gout in a cohort of young men.
Methods
This nationwide population-based cohort study included men aged 20 to 39 years who participated in serial health checks. The outcome, incident gout, was defined by the gout diagnosis code from the claims database. Associations between MetS changes and incident gout were analyzed with Cox proportional hazards models.
Results
Among 1,293,166 subjects , 18,473 were diagnosed with gout (incidence rate 3.36/1,000 person-years). Subjects who had chronic MetS (MetS at all three health controls) had a nearly four-fold higher risk of incident gout than subjects who did not have MetS (no MetS at all three health controls; aHR [95% CI] 3.82 [3.67–3.98]).
The development of MetS more than doubled the risk of incident gout (aHR 2.31 [2.20–2.43]). In contrast, MetS recovery reduced the risk of incident gout by almost half (aHR 0.52 [0.49–0.56]).
Among MetS components, changes in elevated triglycerides (development, aHR 1.74 [1.66–1.81]; recovery, aHR 0.56 [0.54–0.59]) and abdominal obesity (development , aHR 1.94 [1.85–2.03]; recovery, aHR 0.69 [0.64–0.74]) showed the greatest association with altered risk of incident gout.
The associations between MetS changes and incident gout were more pronounced in subjects in their 20s than in subjects in their 30s and in subjects who were underweight or normal weight.
Conclusions
Changes in MetS status were associated with altered risk of incident gout. These results suggest that MetS is a modifiable risk factor for gout.
