Clinical Rheumatology

, Volume 33, Issue 4, pp 549–553 | Cite as

The degree of asymptomatic hyperuricemia and the risk of gout. A retrospective analysis of a large cohort

  • Hadar Duskin-Bitan
  • Eytan Cohen
  • Elad Goldberg
  • Tzippy Shochat
  • Amos Levi
  • Moshe Garty
  • Ilan KrauseEmail author
Original Article


This study was conducted to examine the relationship between the degree of asymptomatic hyperuricemia and the development of gout, in men and women. The database of a screening center was searched for all subjects with asymptomatic hyperuricemia (>7.0 mg/dl men, >5.6 mg/dl women) during 2000–2012. We included men and women without previous diagnosis of gout, and a follow-up of at least 5 years. The risk of gout was analyzed in relation to the degree of hyperuricemia at the first visit. Of the 5,234 subjects who matched the inclusion criteria, 4,241 were normouricemic at their first visit and 993 were hyperuricemic. The mean follow up period was 7.5 years. Gout was diagnosed at the last visit in 34 subjects; four in the normouricemia group and 30 in the hyperuricemia group (0.1 % vs. 3.0 %, p < 0.001). Only one woman developed gout. The odds ratio (OR) for developing gout was 32 times higher in the hyperuricemic group than in the normouricemic group. The OR to develop gout was 11.2 (confidence interval [CI] 3.6–35.2) in men with mild hyperuricemia compared to 107.1 (CI 34.2–334.9) in men with moderate hyperuricemia, and 624.8 (CI 134.0–2,913.1) in men with severe hyperuricemia. Multivariate analysis of uric acid levels, thiazide use, regular alcohol consumption and estimated glomerular filtration rate (eGFR) showed that only the level of uric acid retained statistically significant for increasing the risk of gout. There is a strong association between the absolute level of uric acid and the risk to develop gout, strikingly so for men with severe hyperuricemia. Monitoring is recommended for that group, which poses the greatest risk to develop gout.


Alcohol Arthritis Gender Renal function Thiazide Uric acid 


Conflict of interest

None of the authors have any conflict of interest.


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Copyright information

© Clinical Rheumatology 2014

Authors and Affiliations

  • Hadar Duskin-Bitan
    • 1
    • 2
  • Eytan Cohen
    • 1
    • 2
  • Elad Goldberg
    • 1
    • 2
  • Tzippy Shochat
    • 1
  • Amos Levi
    • 1
    • 2
  • Moshe Garty
    • 2
    • 3
  • Ilan Krause
    • 1
    • 2
    Email author
  1. 1.Department of Internal Medicine F - Recanati, Rabin Medical CenterPetah TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityRamat AvivIsrael
  3. 3.Recanati Center for Preventative Medicine, Rabin Medical CenterPetah TikvaIsrael

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