A study using data from the China Kadoorie Biobank study (CKB) and led by researchers from Oxford Population Health and Peking University has found that gout is linked to increased risk of several diseases.
Gout is the most common form of inflammatory arthritis. The study, published today in The Lancet Regional Health – Western Pacific, provides a comprehensive assessment of the distribution pattern of gout and hyperuricemia (the sustained elevated blood urate level, a measure of the amount of uric acid in the blood and a precursor of gout) and their relationships with a range of other diseases in a Chinese population. The findings may inform prevention and management approaches in China and globally.
The researchers analysed data from 0.5 million CKB participants recruited between 2004 and 2008 from ten diverse urban and rural areas in China. All participants had comprehensive baseline self-reported information on lifestyle risk factors and medical history and were followed up for 12 years with linked electronic health records, with 16,800 participants also having blood plasma urate level measured.
The researchers examined how common gout and hyperuricemia were in difference socio-demographic subgroups, and then looked at the relationships between gout and 16 major conditions and death from all causes.
Key findings:
- In the Chinese population, gout and hyperuricemia were more common in men, urban residents and older participants, with substantial geographical variation across ten study regions;
- Gout was associated with an almost two-fold increased risk of cardiovascular disease (including ischaemic heart disease and stroke), about two and a half times the risk of urolithiasis (kidney stones), and over five times the risk of chronic kidney disease, confirming findings from previous studies in Western populations;
- Gout was also associated with increased risk of several diseases for which previous evidence was limited or inconsistent, including a two-fold increased risk of diabetes, diseases of the oesophagus, stomach and duodenum, and a six-fold increased risk of arthropathies (diseases of the joint);
- Most of these associations were bi-directional (meaning the diseases also increase future risk of gout), and were not fully explained by shared lifestyle and cardiometabolic risk factors;
- Overall, individuals who developed gout were more likely to have multiple conditions, more hospitalisations, and higher risk of premature death.
Pek Kei Im, Senior Epidemiologist at Oxford Population Health and lead author of the paper, said ‘Gout has become more common around the world over the past 30 years. Our study demonstrates that gout is also linked to a number of other diseases and conditions. This knowledge can inform prevention and management strategies of gout and related diseases in China and elsewhere.
‘Findings on the socio-demographic variation in hyperuricemia and gout occurrence may inform targeted screening and prevention strategies at local and national levels, including approaches to address risk factors through changes to lifestyle and improve timely access and adherence to treatment.’
Iona Millwood, Associate Professor at Oxford Population Health and joint senior author of the study, added ‘Our findings may also inform prevention and management guidelines for gout, which could include assessment and monitoring of a wider range of comorbidities. Our study opens the door for further studies to investigate the causal relationship and explore how gout affects risk of developing other diseases, which may translate to effective prevention and new therapies for multiple diseases.’