Gender-specific risk factors for gout: a systematic review of cohort studies

Abstract

Background: Though gout is more prevalent in men than women, it remains unclear whether gender influences risk factors for incident gout. We aimed to systematically review all cohort studies examining risk factors for the development of gout by gender. Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched from inception to March 2019. Risk factors for gout examined were: age, ethnicity, consumption of alcohol, meat, seafood, dairy products, purine-rich vegetables, coffee and fructose, vitamin C intake, the Dietary Approaches to Stop Hypertension (DASH) diet, metabolic syndrome, BMI, waist and chest circumference, waist-to-hip ratio, weight change, diabetes mellitus, dyslipidaemias, renal disease, psoriasis, hypertension, diuretic use and anti-diabetic medication. Cohort studies were included if examining (at least) one of these risk factors for gout in either gender in the general population or primary care. Sample characteristics from included articles and their reported risk estimates were described using narrative synthesis. Results: Thirty-three articles were included, 20 (60.6%)directly compared risk factors by gender, 10 (30.3%) used men-only samples, 3 (9.1%) used women-only samples. Articles comparing risk across genders found similar increases in most risk factors. However, in men, metabolic syndrome (Hazard Ratio (95% CI) 1.37(1.20-1.58)) presented a risk of incident gout compared to none in women (> 50 years 1.15(0.85-1.54); ≤50 years 1.29(0.76-2.17)). Compared to men, women showed greater associated risk with higher consumption of fish and shellfish (HR (95% CI) Men: 1.02 (0.86-1.22); Women 1.36 (1.12-1.65)). Conclusions: Risk factors for developing gout did not typically differ between genders and therefore similar preventative advice can be provided. Exceptions were metabolic syndrome in men and excessive seafood consumption in women, but these singular articles need further examination and in general more research into the risk factors for gout which includes women is required.

Correlation Between Obesity and Hypertension with Gout Arthritis: A Cross-Sectional Study

“…As a comparison, the prevalence of increasing uric acid levels in nutritional people is more than 2.98 times more than people with malnutrition and in obese people it is 5.96 times more than people with malnutrition [9]. Gout is 2.2 times more likely to occur in individuals with a body mass index ≥ 30 kg / m2 [2].…”

“…Long-lasting hyperuricemia can cause chronic kidney disease with tubular changes. Hypertensive individuals were 1.64 (1.34-2.01) and 2.11 (1.64-2.72) times more likely to develop gout as a normotensive individual [2].…”

“…Obesity increases insulin resistance, which reduces renal excretion and leads in hyperuremia. Hypertension is gout predisposition which reduces vein excretion due to glomerular artery damage and glomerulosclerosis [2].…”

Using multiple Mendelian randomization approaches and genetic correlations to understand obesity, urate, and gout

“…A third limitation is that we were unable to examine sex-specific effects of obesity on urate or gout. Globally, the prevalence of obesity is higher for women (15%) than men (11%) 49 , yet gout is more common in men 50 . A fourth limitation is that our findings are only applicable to those of European ancestry.…”

The Association between Serum Testosterone and Hyperuricemia in Males

“…Recent studies have shown varying results regarding the relationship between total testosterone and SU levels. Some studies have shown a positive association [ 11 , 12 , 13 , 14 ], and other studies have shown a negative association [ 15 , 16 , 17 , 18 , 19 , 20 ].…”