Body mass index and the risk of gout: a systematic review and dose–response meta-analysis of prospective studies
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Greater body fatness has been associated with increased risk of gout in several studies; however, the strength of the association has differed between studies, and it is not clear whether the association differs by gender. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of gout.
PubMed and Embase were searched up to August 30, 2013. Summary relative risks (RRs) were calculated using a random effects model.
Ten prospective studies of body mass index (BMI) and gout risk with 27,944 cases and 215,739 participants were included (median follow-up 10.5 years). The summary RR for a 5 unit increment was 1.55 [95 % confidence interval (95 % CI) 1.44–1.66, I 2 = 67 %] for all studies combined. The heterogeneity was explained by one study, which appeared to be an outlier. The summary RR per 5 BMI units was 1.62 (95 % CI 1.33–1.98, I 2 = 79 %) for men and 1.49 (95 % CI 1.32–1.68, I 2 = 30 %) for women, p heterogeneity = 0.72. The relative risks were 1.78, 2.67, 3.62, and 4.64 for persons with BMI 25, 30, 35, and 40 compared with persons with a BMI of 20. BMI in young adulthood, waist-to-hip ratio, and weight gain from age 21–25 to midlife were also associated with increased risk, but few studies were included in these analyses.
Greater body mass index increases risk of gout. Further studies are needed on adiposity throughout the life course, waist-to-hip ratio, and weight changes in relation to gout as there were few studies that had published on these exposures.
KeywordsBody mass index Waist-to-hip ratio Weight gain Gout Meta-analysis
This project has been supported by the “Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU).” The funding agency had no role in the conception and design of the study, the planning or conduct of the analyses, writing or revision of the manuscript.
Conflict of interest
The authors declare that they have no conflict of interest.
The manuscript does not contain clinical studies or patient data.
- 3.Wallace KL, Riedel AA, Joseph-Ridge N, Wortmann R (2004) Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population. J Rheumatol 31:1582–1587Google Scholar
- 4.Arromdee E, Michet CJ, Crowson CS, O’Fallon WM, Gabriel SE (2002) Epidemiology of gout: is the incidence rising? J Rheumatol 29:2403–2406Google Scholar
- 5.Chuang SY, Lee SC, Hsieh YT, Pan WH (2011) Trends in hyperuricemia and gout prevalence: nutrition and Health Survey in Taiwan from 1993-1996 to 2005-2008. Asia Pac J Clin Nutr 20:301–308Google Scholar
- 9.Williams PT (2008) Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. Am J Clin Nutr 87:1480–1487Google Scholar
- 16.Lin KC, Lin HY, Chou P (2000) Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J Rheumatol 27:1045–1050Google Scholar
- 17.Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRefGoogle Scholar
- 18.Wells G, Shea B, O’Connell D., Peterson J, Welch V, Losos M, Tugwell P (2013) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 23 Sept 2013
- 20.Aune D, Greenwood DC, Chan DS, Vieira R, Vieira AR, Navarro Rosenblatt DA, Cade JE, Burley VJ, Norat T (2012) Body mass index, abdominal fatness and pancreatic cancer risk: a systematic review and non-linear dose-response meta-analysis of prospective studies. Ann Oncol 23:843–852CrossRefGoogle Scholar
- 22.Greenland S, Longnecker MP (1992) Methods for trend estimation from summarized dose-response data, with applications to meta-analysis. Am J Epidemiol 135:1301–1309Google Scholar
- 27.Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, Matsuzawa Y (1998) Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 47:929–933CrossRefGoogle Scholar
- 31.Yamashita S, Matsuzawa Y, Tokunaga K, Fujioka S, Tarui S (1986) Studies on the impaired metabolism of uric acid in obese subjects: marked reduction of renal urate excretion and its improvement by a low-calorie diet. Int J Obes 10:255–264Google Scholar