Skip to main content

Advertisement

SpringerLink
Log in

Risk of gout in Taiwan Biobank participants pertaining to their sex and family history of gout among first-degree relatives

  • Research
  • Published:
Clinical and Experimental Medicine Aims and scope Submit manuscript

Abstract

Background

Family history of gout and sex are independently associated with gout. However, there is a paucity of research regarding the joint role of both factors in gout pathogenesis. Therefore, we assessed the independent and combined association of family history of gout and sex with gout.

Methods

Our analysis included 132,311 Taiwan Biobank (TWB)-enrolled individuals comprising 21,159 gout cases and 111,152 controls. We subcategorized the family history of gout as (1) both siblings and parents had gout), (2) only parents had gout, and (3) only siblings had gout.

Results

Generally, sex (men compared to women) and family history of gout were independently associated with a higher risk of gout. The odds ratio (OR); 95% confidence interval (CI) was 9.175; 8.801–9.566 for sex, and 2.306; 2.206–2.410 for family history. For the subcategories ‘both siblings and had gout,’ ‘only parents had gout,’ and ‘only siblings had gout,’ the odds ratios (ORs); 95% confidence intervals (CIs) were 4.944; 4.414–5.538, 2.041; 1.927–2.161, and 2.162; 2.012–2.323, respectively. The interaction between sex and family history was significant (p value = 0.0001). After stratification by sex, family history of gout remained significantly associated with a higher risk of gout in both sexes, even though the odds ratios were higher in men. For the subcategories ‘both siblings and parents had gout,’ ‘only parent had gout,’ and ‘only siblings had gout,’ the corresponding ORs; 95% CIs were 6.279; 5.243–7.520, 2.211; 2.062–2.371, and 2.148; 1.955–2.361 in men and 4.199; 3.566–4.945, 1.827; 1.640–2.035, and 2.093; 1.876–2.336 in women. After integrating sex and family history (reference: women with no family history), the highest risk of gout was observed in men who had at least one parent and sibling with a history of gout (OR; 95% CI 55.774; 46.360–67.101).

Conclusion

Sex and family history of gout were independently and interactively associated with gout. Sex-wise, men had a higher risk of gout than women. Family history was associated with a higher risk of gout in both sexes, but men had a higher risk. Notably, men having both siblings and parents with gout had the highest risk of gout.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Availability of data and materials

The data that support the findings of this study are available from Taiwan Biobank but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the corresponding author, Prof. Yung-Po Liaw upon reasonable request and with permission of Taiwan Biobank.

References

  1. MacFarlane LA, Kim SC. Gout: a review of nonmodifiable and modifiable risk factors. Rheum Dis Clin. 2014;40(4):581–604.

    Google Scholar 

  2. Bhole V, de Vera M, Rahman MM, Krishnan E, Choi H. Epidemiology of gout in women: Fifty-two-year followup of a prospective cohort. Arthritis Rheum. 2010;62(4):1069–76.

    PubMed  Google Scholar 

  3. Trifirò G, Morabito P, Cavagna L, et al. Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study. Ann Rheum Dis. 2013;72(5):694–700.

    PubMed  Google Scholar 

  4. Kopke A, Greeff OB. Hyperuricaemia and gout. S Afr Fam Pract. 2015;57(1):6–12.

    Google Scholar 

  5. Singh JA, Reddy SG, Kundukulam J. Risk factors for gout and prevention: a systematic review of the literature. Curr Opin Rheumatol. 2011;23(2):192.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Lin K-C, Lin H, Chou P. The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study. J Rheumatol. 2000;27(6):1501–5.

    CAS  PubMed  Google Scholar 

  7. Li-Yu J, Clayburne G, Sieck M, et al. Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout? J Rheumatol. 2001;28(3):577–80.

    CAS  PubMed  Google Scholar 

  8. Gao Q, Cheng X, Merriman TR, et al. Trends in the manifestations of 9754 gout patients in a Chinese clinical center: a 10-year observational study. Joint Bone Spine. 2021;88(6): 105078.

    CAS  PubMed  Google Scholar 

  9. Roddy E, Doherty M. Gout. Epidemiology of gout. Arthritis Res Ther. 2010;12(6):1–11.

    Google Scholar 

  10. Annemans L, Spaepen E, Gaskin M, et al. Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000–2005. Ann Rheum Dis. 2008;67(7):960–6.

    CAS  PubMed  Google Scholar 

  11. Padang C, Muirden KD, Schumacher HR, Darmawan J, Nasution AR. Characteristics of chronic gout in Northern Sulawesi, Indonesia. J Rheumatol. 2006;33(9):1813–7.

    PubMed  Google Scholar 

  12. Wu EQ, Patel PA, Mody RR, et al. Frequency, risk, and cost of gout-related episodes among the elderly: does serum uric acid level matter? J Rheumatol. 2009;36(5):1032–40.

    PubMed  Google Scholar 

  13. Wallace KL, Riedel AA, Joseph-Ridge N, Wortmann R. Increasing prevalence of gout and hyperuricemia over 10 years among older adults in a managed care population. J Rheumatol. 2004;31(8):1582–7.

    PubMed  Google Scholar 

  14. Wang W, Krishnan E. Cigarette smoking is associated with a reduction in the risk of incident gout: results from the Framingham Heart Study original cohort. Rheumatology. 2015;54(1):91–5.

    CAS  PubMed  Google Scholar 

  15. Dehlin M, Jacobsson L, Roddy E. Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors. Nat Rev Rheumatol. 2020;16(7):380–90.

    PubMed  Google Scholar 

  16. Singh JA, Gaffo A. Gout epidemiology and comorbidities. Sem Arthritis Rheum. 2020;50:S11–6.

    Google Scholar 

  17. Lyu L-C, Hsu C-Y, Yeh C-Y, Lee M-S, Huang S-H, Chen C-L. A case-control study of the association of diet and obesity with gout in Taiwan. Am J Clin Nutr. 2003;78(4):690–701.

    CAS  PubMed  Google Scholar 

  18. Chuang S-Y, Lee S-C, Hsieh Y-T, Pan W-H. Trends in hyperuricemia and gout prevalence: Nutrition and Health Survey in Taiwan from 1993–1996 to 2005–2008. Asia Pac J Clin Nutr. 2011;20(2):301–8.

    CAS  PubMed  Google Scholar 

  19. Lin K-C, Lin H-Y, Chou P. Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J Rheumatol. 2000;27(4):1045–50.

    CAS  PubMed  Google Scholar 

  20. Harrold LR, Etzel CJ, Gibofsky A, et al. Sex differences in gout characteristics: tailoring care for women and men. BMC Musculoskelet Disord. 2017;18(1):1–6.

    Google Scholar 

  21. Harrold LR, Yood RA, Mikuls TR, et al. Sex differences in gout epidemiology: evaluation and treatment. Ann Rheum Dis. 2006;65(10):1368–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. De Souza AW, Fernandes V, Ferrari AJ. Female gout: clinical and laboratory features. J Rheumatol. 2005;32(11):2186–8.

    PubMed  Google Scholar 

  23. Zitt E, Fischer A, Lhotta K, Concin H, Nagel G. Sex-and age-specific variations, temporal trends and metabolic determinants of serum uric acid concentrations in a large population-based Austrian cohort. Sci Rep. 2020;10(1):1–8.

    Google Scholar 

  24. Evans PL, Prior JA, Belcher J, Hay CA, Mallen CD, Roddy E. Gender-specific risk factors for gout: a systematic review of cohort studies. Adv Rheumatol. 2019. https://doi.org/10.1186/s42358-019-0067-7.

    Article  PubMed  Google Scholar 

  25. Vitart V, Rudan I, Hayward C, et al. SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout. Nat Genet. 2008;40(4):437–42.

    CAS  PubMed  Google Scholar 

  26. Dehghan A, Köttgen A, Yang Q, et al. Association of three genetic loci with uric acid concentration and risk of gout: a genome-wide association study. The Lancet. 2008;372(9654):1953–61.

    CAS  Google Scholar 

  27. Köttgen A, Albrecht E, Teumer A, et al. Genome-wide association analyses identify 18 new loci associated with serum urate concentrations. Nat Genet. 2013;45(2):145–54.

    PubMed  Google Scholar 

  28. Wang WH, Chang SJ, Wang TN, et al. Complex segregation and linkage analysis of familial gout in Taiwanese aborigines. Arthritis Rheum. 2004;50(1):242–6.

    CAS  PubMed  Google Scholar 

  29. Krishnan E, Lessov-Schlaggar CN, Krasnow RE, Swan GE. Nature versus nurture in gout: a twin study. Am J Med. 2012;125(5):499–504.

    PubMed  Google Scholar 

  30. Wilk JB, Djousse L, Borecki I, et al. Segregation analysis of serum uric acid in the NHLBI Family Heart Study. Hum Genet. 2000;106(3):355–9.

    CAS  PubMed  Google Scholar 

  31. Emmerson B, Nagel S, Duffy D, Martin N. Genetic control of the renal clearance of urate: a study of twins. Ann Rheum Dis. 1992;51(3):375–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Chang S, Ko YC, Wang T, Chang F, Cinkotai F, Chen C. High prevalence of gout and related risk factors in Taiwan’s Aborigines. J Rheumatol. 1997;24(7):1364–9.

    CAS  PubMed  Google Scholar 

  33. Chou C, Lai J. The epidemiology of hyperuricaemia and gout in Taiwan aborigines. Br J Rheumatol. 1998;37(3):258–62.

    CAS  PubMed  Google Scholar 

  34. Chandratre P, Roddy E, Clarson L, Richardson J, Hider SL, Mallen CD. Health-related quality of life in gout: a systematic review. Rheumatology. 2013;52(11):2031–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Kuo C-F, Grainge MJ, See L-C, et al. Epidemiology and management of gout in Taiwan: a nationwide population study. Arthritis Res Ther. 2015;17(1):1–10.

    Google Scholar 

  36. Yu KH, Luo SF. Younger age of onset of gout in Taiwan. Rheumatology. 2003;42(1):166–70.

    PubMed  Google Scholar 

  37. Kuo C-F, Grainge MJ, See L-C, et al. Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan. Ann Rheum Dis. 2015;74(2):369–74.

    PubMed  Google Scholar 

  38. Chen S-Y, Chen C-L, Shen M-L, Kamatani N. Clinical features of familial gout and effects of probable genetic association between gout and its related disorders. Metabol Clin Exp. 2001;50(10):1203–7.

    CAS  Google Scholar 

  39. Feng Y-CA, Chen C-Y, Chen T-T, et al. Taiwan Biobank: a rich biomedical research database of the Taiwanese population. Cell Genom. 2022;2(11):100197–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Fan C-T, Lin J-C, Lee C-H. Taiwan Biobank: a project aiming to aid Taiwan’s transition into a biomedical island. Pharmacogenomics. 2008;9:235–46.

    PubMed  Google Scholar 

  41. Tsai H-H, Shen C-Y, Ho C-C, et al. Interaction between a diabetes-related methylation site (TXNIP cg19693031) and variant (GLUT1 rs841853) on fasting blood glucose levels among non-diabetics. J Transl Med. 2022;20(1):1–9.

    Google Scholar 

  42. Hsu T-L, Tantoh DM, Chou Y-H, et al. Association between osteoporosis and menopause in relation to SOX6 rs297325 variant in Taiwanese women. Menopause (New York, NY). 2020;27(8):887.

    Google Scholar 

  43. Liu C-S, Li T-C, Lin C-C. The epidemiology of hyperuricemia in children of Taiwan aborigines. J Rheumatol. 2003;30(4):841–5.

    CAS  PubMed  Google Scholar 

  44. Lu X, Li X, Zhao Y, Zheng Z, Guan S, Chan P. Contemporary epidemiology of gout and hyperuricemia in community elderly in Beijing. Int J Rheum Dis. 2014;17(4):400–7.

    PubMed  Google Scholar 

  45. Chen S-Y, Shen M-L. Juvenile gout in Taiwan associated with family history and overweight. J Rheumatol. 2007;34(11):2308–11.

    PubMed  Google Scholar 

  46. Wang Y, Yan S, Li C, et al. Risk factors for gout developed from hyperuricemia in China: a five-year prospective cohort study. Rheumatol Int. 2013;33(3):705–10.

    CAS  PubMed  Google Scholar 

  47. Mohd A, Das Gupta E, Loh Y, Gandhi C, D’souza B, Gun S. Clinical characteristics of gout: a hospital case series. Malays Fam Physician. 2011;6(2–3):72.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Choi HK, Atkinson K, Karlson EW, Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med. 2005;165(7):742–8.

    PubMed  Google Scholar 

  49. Nicholls A, Snaith M, Scott J. Effect of oestrogen therapy on plasma and urinary levels of uric acid. Br Med J. 1973;1(5851):449–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Sumino H, Ichikawa S, Kanda T, Nakamura T, Sakamaki T. Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia. The Lancet. 1999;354(9179):650.

    CAS  Google Scholar 

  51. Hak AE, Choi HK. Menopause, postmenopausal hormone use and serum uric acid levels in US women—the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10(5):1–7.

    Google Scholar 

  52. Hak AE, Curhan GC, Grodstein F, Choi HK. Menopause, postmenopausal hormone use and risk of incident gout. Ann Rheum Dis. 2010;69(7):1305–9.

    PubMed  Google Scholar 

  53. Yahyaoui R, Esteva I, Haro-Mora J, et al. Effect of long-term administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons. J Clin Endocrinol Metab. 2008;93(6):2230–3.

    CAS  PubMed  Google Scholar 

  54. McCormick N, Rai SK, Lu N, Yokose C, Curhan GC, Choi HK. Estimation of primary prevention of gout in men through modification of obesity and other key lifestyle factors. JAMA Netw Open. 2020;3(11):e2027421–e2027421.

    PubMed  PubMed Central  Google Scholar 

  55. Soriano LC, Rothenbacher D, Choi HK, Rodríguez LAG. Contemporary epidemiology of gout in the UK general population. Arthritis Res Ther. 2011;13(2):1–9.

    Google Scholar 

  56. Williams PT. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. Am J Clin Nutr. 2008;87(5):1480–7.

    CAS  PubMed  Google Scholar 

  57. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. The Lancet. 2004;363(9417):1277–81.

    Google Scholar 

  58. Wang M, Jiang X, Wu W, Zhang D. A meta-analysis of alcohol consumption and the risk of gout. Clin Rheumatol. 2013;32(11):1641–8.

    PubMed  Google Scholar 

  59. Zhang Y, Woods R, Chaisson CE, et al. Alcohol consumption as a trigger of recurrent gout attacks. Am J Med. 2006;119(9):800.e811-800.e816.

    Google Scholar 

  60. Maclachlan MJ, Rodnan GP. Effects of food, fast and alcohol on serum uric acid and acute attacks of gout. Am J Med. 1967;42(1):38–57.

    CAS  PubMed  Google Scholar 

  61. Kim Y, Kang J. Association of urinary cotinine-verified smoking status with hyperuricemia: Analysis of population-based nationally representative data. Tobacco Induced Dis. 2020;18:1–10.

    CAS  Google Scholar 

  62. Hanna BE, Hamed JM, Touhala LM. Serum uric Acid in smokers. Oman Med J. 2008;23(4):269.

    PubMed  PubMed Central  Google Scholar 

  63. Tsuchiya M, Asada A, Kasahara E, Sato EF, Shindo M, Inoue M. Smoking a single cigarette rapidly reduces combined concentrations of nitrate and nitrite and concentrations of antioxidants in plasma. Circulation. 2002;105(10):1155–7.

    CAS  PubMed  Google Scholar 

  64. Janssens HJ, van de Lisdonk EH, Janssen M, van den Hoogen HJ, Verbeek AL. Gout, not induced by diuretics? A case-control study from primary care. Ann Rheum Dis. 2006;65(8):1080–3.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

The Ministry of Science and Technology (MOST), Taiwan funded our study (MOST 111-2121-M-040-002).

Author information

Authors and Affiliations

  1. Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Hao-Hung Tsai, Chih-Yi Chen & Yung-Po Liaw

  2. College of Medicine, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Hao-Hung Tsai

  3. Department of Medical Imaging, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Hao-Hung Tsai, Disline Manli Tantoh & Yung-Po Liaw

  4. Department of Medical Imaging, School of Medicine, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Hao-Hung Tsai

  5. Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Hao-Hung Tsai

  6. Department of Public Health and Institute of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Disline Manli Tantoh, Chih-Hsuan Hsiao, Ji-Han Zhong & Yung-Po Liaw

  7. Division of Thoracic Surgery, Department of Surgery, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan

    Chih-Yi Chen

Authors
  1. Hao-Hung Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Disline Manli Tantoh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chih-Hsuan Hsiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ji-Han Zhong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chih-Yi Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yung-Po Liaw
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

H-HT, DMT, C-HH, J-HZ, C-YC, and Y-PL did the literature search, conceived, and designed the study. C-HH, J-HZ, and Y-PL analyzed the data. H-HT, DMT, and C-YC drafted the manuscript. DMT edited the paper. All the authors reviewed and approved the final version of the manuscript.

Corresponding authors

Correspondence to Chih-Yi Chen or Yung-Po Liaw.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Consent for publication

Not applicable.

Ethics approval and consent to participate

The Institutional Review Board (IRB) of the Chung Shan Medical University Hospital granted ethical approval for this study (IRB: CS1-20009). Each participant signed an informed consent letter before enrolling in the Taiwan Biobank project. All methods were carried out in accordance with relevant guidelines and regulations.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 19 kb)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tsai, HH., Tantoh, D.M., Hsiao, CH. et al. Risk of gout in Taiwan Biobank participants pertaining to their sex and family history of gout among first-degree relatives. Clin Exp Med 23, 5315–5325 (2023). https://doi.org/10.1007/s10238-023-01167-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10238-023-01167-1

Keywords

Search

Navigation