Changes in metabolic syndrome status may be associated with an altered risk for incident gout among young men, suggesting that metabolic syndrome may be a modifiable risk factor for gout, according to study findings published in Arthritis & Rheumatology.
Researchers in South Korea conducted a retrospective, nationwide, population-based study to investigate the relationship between incident gout and metabolic syndrome status among young men aged from 20 to 39 years. Men who participated in a first health checkup between 2009 and 2012 and 2 additional health checkups at 2-year intervals thereafter were included in the study.
Of 1,293,166 young men who met eligibility criteria, 18,473 were newly diagnosed with gout during 1 of their health check-ups. The incidence rate of gout among these men was calculated as 3.36 per every 1000-person-years.
Young men with chronic metabolic syndrome based on diagnosis codes in electronic medical records and drug prescriptions at all 3 health check-ups demonstrated a 4-fold higher risk of developing gout than those who remained metabolic syndrome-free (adjusted hazard ratio [aHR], 3.82; 95% CI, 3.67-3.98).
Development of metabolic syndrome doubled the risk for gout (aHR, 2.31; 95% CI, 2.20-2.43) and recovery reduced the risk for gout onset by half (aHR, 0.52; 95% CI, 0.49-0.56).
Primary changes related to metabolic syndrome that correlated with development or reduction of gout included changes in elevated triglycerides (development aHR, 1.74; 95% CI, 1.66-1.81; recovery aHR, 0.56; 95% CI, 0.54-0.59) and abdominal obesity (development aHR, 1.94; 95% CI, 1.85-2.03; recovery aHR: 0.69; 95% CI, 0.64-0.74).
Young men in their 20s vs 30s who were considered underweight or normal weight had stronger correlations between incident gout and metabolic syndrome.
Study limitations included selection bias and the lack of generalizability of results to other populations. In addition, health checkup results on electronic medical records and drug claims were used to define metabolic syndrome, which may have led to misclassification. Moreover, the researchers were unable to determine whether changes in metabolic syndrome affected the incidence of gout through hyperuricemia or other mechanisms based on a lack of assessment of serum urate levels.
“This study has several practical implications,” the researchers said. “First, the development of MetS in young men can increase gout risk, and a history of MetS might be associated with a subsequent increase in the risk of gout, even if individuals recover from MetS. Therefore, strategies for primary prevention of MetS are necessary. In addition, since recovery from MetS can lower the risk of gout, it is important to implement strategies such as lifestyle modification and appropriate pharmacologic treatment for MetS management in young men,” they added.
Eun Y, Han K, Lee SW, et al. Altered risk of incident gout according to changes in metabolic syndrome status: A nationwide population-based cohort study of 1.29 million young men. Arthritis Rheumatol. Published online November 22, 2022. doi:10.1002/art.42381