Development of Metabolic Syndrome More Than Doubles the Risk of Gout

The burden of gout is increasing globally. The common form of inflammatory arthritis has been linked with several comorbidities, such as chronic kidney disease, cardiovascular disease, diabetes, depression, and sleep apnea. Gout is more likely to occur in men, and the risk of gout significantly increases with age.

Metabolic syndrome, a cluster of conditions that occur together, includes conditions such as increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels. These conditions combined significantly increase an individual’s risk of heart disease, stroke, and type 2 diabetes. The management of metabolic syndrome have been emphasized in the prevention of cardiovascular disease. Furthermore, prior studies have demonstrated that changes in metabolic syndrome status can alter the risk of atrial fibrillation and end-stage renal disease.

Prior to a study published in Arthritis & Rheumatology, the question of whether a change in metabolic status can alter the risk of gout had not been answered. In a recent large nationwide population-based cohort study, nearly 1.3 million men aged 20 to 39 years underwent three health check-ups at 2-year intervals. The primary outcome measurement was incident gout. Researchers used Cox proportional hazard models to analyze the associations between metabolic syndrome changes and incident gout.

Over the duration of the study period, 18,473 men were diagnosed with gout, and the incidence rate of gout was 3.36 per 1000 person-years. Patients who had metabolic syndrome at all three checkups had near four times higher risk of incident gout compared with patients who were did not have metabolic syndrome. In addition, patients who developed metabolic syndrome over the study period had nearly double the risk of incident gout.

Researchers also found that two components of metabolic syndrome, elevated triglycerides and abdominal obesity, had the greatest association with altered risk of incident gout. Patients who had metabolic syndrome but recovered had a reduced incidence of gout.

In a press release published online in Wiley, Jaejoon Lee, MD, PhD, of the Sungkyunkwan University School of Medicine in South Korea, remarked “This is the first large-scale study to explore the association between dynamic changes in metabolic syndrome and risk of gout. Prevention and recovery from metabolic syndrome can significantly lower the risk of gout in young adults.”