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Increased risk of incident gout in patients with hyperthyroidism: a nationwide retrospective cohort study

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Abstract

Previous studies have reported that thyroid dysfunction is associated with increased serum uric acid levels; however, the relationship between hyperthyroidism and incidence of clinical manifestations of gout has not been fully investigated. Therefore, this study aimed to longitudinally investigate the risk of gout in patients with hyperthyroidism. This nationwide retrospective cohort study used data from the Korean National Health Claims Database. We included 76,494 patients with hyperthyroidism and 76,542 age- and sex-matched controls. A Cox proportional hazard regression model was used to adjust for potential confounders and estimate the risk of incident gout in patients with hyperthyroidism. During a mean follow-up of 9 years, incident gout developed in 3,655 (4.8%) patients with hyperthyroidism and 3251 (4.2%) controls. Hyperthyroidism was significantly associated with increased risk of incident gout [adjusted hazard ratio (HR), 1.12; 95% confidence interval (CI) 1.07–1.18], independent of baseline metabolic profiles. The median time from the diagnosis of hyperthyroidism to the development of gout was 6 years. When stratified by age and sex, the risk of gout was still significant in the < 50-year age group (HR: 1.2, 95% CI 1.12–1.29) and males (HR: 1.21, 95% CI 1.12–1.30), but not in the older age group (> 50 years) and females. Hyperthyroidism is an important risk factor for incident gout, particularly in younger age groups (< 50 years) and males. Our results highlight the importance of continuous screening for gout in patients with hyperthyroidism.

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Data availability

The authors are restricted from sharing the data in this study, because the Korean National Health Insurance Service (NHIS) owns the data. Researchers can request access on the NHIS at https://nhiss.nhis.or.kr. Details of this process are available at http://nhiss.nhis.or.kr/bd/ab/bdaba000eng.do.

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing. No Artificial Intelligence software was used to draft or edit the manuscript.

Funding

This work was supported by a faculty grant from Myongji Hospital (grant number 2201-03-04).

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Authors and Affiliations

  1. Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea

    Ju-Yeun Lee

  2. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea

    Ju-Yeun Lee

  3. Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, South Korea

    Ju-Yeun Lee

  4. Division of Rheumatology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea

    So-Yeon Park

  5. Division of Endocrinology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea

    Seo Young Sohn

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Contributions

All authors meet the ICMJE criteria for authorship and contributed to the study conception and design of this work. Data collection and interpretation were performed by JYL and SYS, and the statistical analysis was performed by JYL. The first draft of the manuscript was written by JYL and revised by SYP and SYS. All the authors read and approved the final manuscript. All authors take full responsibility for the integrity and accuracy of all aspects of the work.

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Correspondence to Seo Young Sohn.

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Conflict of interest

Ju-Yeun Lee, So-Yeon Park and Seo Young Sohn declare that the authors have no conflict of interest.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki and was approved by the institutional review board of Myongji hospital, Hanyang University College of Medicine on November 12, 2021. The study protocol number is IRB No. 2021-11-020.

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Lee, JY., Park, SY. & Sohn, S.Y. Increased risk of incident gout in patients with hyperthyroidism: a nationwide retrospective cohort study. Rheumatol Int 44, 451–458 (2024). https://doi.org/10.1007/s00296-023-05423-1

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