Simultaneous modification of obesity and other key risk factors may prevent the majority of incident gout cases among men, according to study results published in JAMA Network Open.

Previous research has shown that modifying obesity and other key risk factors may prevent hyperuricemia, but little is known about the proportion of incident gout cases and the modification of obesity and other lifestyle factors.

To determine the association of obesity and other risk factors with the risk for incident gout, data from 44,654 men (mean age, 54.0±9.8 years; 91% White) were analyzed. Individuals aged 40 to 75 years and without a diagnosis of gout at baseline were included in the study. Participants completed questionnaires every 2 years, which included questions related to body mass index (BMI), dietary intake, alcohol consumption, and medication use.


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During the 26-year follow-up, 1741 incident gout cases (3.9%) were identified. The most important risk factor in the development of gout was BMI. Compared to a BMI of less than 23.0, a BMI of 23.0 to 24.9 had a relative risk (RR) of 1.29 (95% CI, 1.06-1.57), which increased with BMI. Alcohol consumption of 5.0 to 9.9 g per day vs 0 g per day had a RR of 1.20 (95% CI, 1.01-1.43). Adhering to Dietary Approaches to Stop Hypertension (DASH)-style diet in the highest vs lowest quintile had a reduced RR of 0.74 (95% CI, 0.63-0.88). Use vs nonuse of diuretics resulted in a RR of 2.10 (95% CI, 1.85-2.39).

Results of the study indicated that 77% of incident gout cases may have been prevented by maintaining a BMI less than 25.0, adhering to a DASH-style diet, abstaining from alcohol, and not using diuretics. More than half of the incident gout cases may be prevented in overweight individuals with a combination of DASH-style diet, no alcohol intake, and no diuretic use. Physicians may find these results useful in recommending lifestyle changes to individuals at risk of developing gout.

One study limitation was the reliance on data from the Health Professionals Follow-up Study, which only included men with specific occupational roles and therefore not representative of the entire population.

“Men with obesity may not benefit from other modifications unless weight loss is addressed,” the researchers added.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

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. doi:10.1001/jamanetworkopen.2020.27421