Elevated Ferritin Levels Associated With Risk for Gout, Flare Frequency

gout of foot
gout of foot
Increased ferritin levels were associated with gout and flare frequency.

Study data published in Arthritis Research and Therapy suggest that elevated ferritin levels are associated with gout and flare frequency.

Researchers recruited healthy controls and patients with gout from New Zealand and the United States for serum biomarker analyses. The New Zealand sample set included men of European (100 cases and 60 controls) and Polynesian descent (100 cases and 60 controls); the US sample included men of Latino, African American, and European ancestry (189 cases and 60 controls). Publicly available cohort data on patients with gout (n=10,727) from the Jackson Heart Study (JHS) and the Third National Health and Nutrition Examination Study (NHANES III) were used for serum ferritin and urate association analyses. Individuals in the JHS cohort were of African American descent (n=1260); patients in NHANES III were of African American (n=4355) and European descent (n=5112).

A positive association between serum urate concentration and serum ferritin concentration was identified in African American individuals without gout from both the JHS and NHANES III, as well as in European individuals without gout from the NHANES III study. Effect sizes were, on average, 2- to 3-fold greater in women compared with men. Correlation between serum ferritin and urate levels was also detected in controls from the New Zealand Polynesian cohort but not from the New Zealand European or US cohorts.

Average ferritin levels were elevated in those with gout compared with controls for the New Zealand Polynesian and US study groups only. A 10 ng/mL increase in serum ferritin levels was associated with an increased risk of developing gout in New Zealand Polynesian (odds ratio [OR], 1.03; 95% CI, 1.01-1.05) and US (OR, 1.11; 95% CI, 1.07-1.17) individuals. Each 10-ng/mL increase in serum ferritin level was associated with an increased frequency of gout flares for patients in the US and New Zealand European cohorts, but not in those in the New Zealand Polynesian cohort.

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These study data provide an extensive map for certain gout biomarkers and support a causal relationship between serum ferritin levels and gout flare frequency. As such, dietary restriction of iron-rich foods could lessen the severity and frequency of flares in patients with gout.

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Fatima T, McKinney C, Major TJ, et al. The relationship between ferritin and urate levels and risk of gout. Arthritis Res Ther. 2018;20:179.