Weight Change Patterns During Adulthood Associated With Incident Gout

overweight man being measured
overweight man being measured
Researchers investigated the association between weight change patterns during adulthood and incident gout.

Obesity and weight gain during adulthood may be a significant risk factor for incident gout, according to study results published in Arthritis Research and Therapy.

Compared with individuals without obesity, those with obesity may be more than twice as likely to develop gout. However, the effect of weight change patterns on incidence of gout is unknown.

Researchers conducted a retrospective longitudinal study using data abstracted from the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of US adults, between 2007 and 2014.

The current study included data from adults aged between 40 and 74 years. The primary outcome was incident gout, determined by self-report. Exposures of interest included body mass index (BMI) at 25 years (“young adulthood”) and 10 years prior to NHANES participation (“midlife”). Changes in BMI patterns between young adulthood and midlife were categorized into 4 groups, including stable non-obese; losing body weight; gaining body weight; and stable obese. Cox proportional hazard models were used to determine the risk for incident gout based on BMI trajectories.  

The study cohort included 11,079 adults aged 40 to 74 years. The distribution of BMI trajectories was 71.7% stable non-obese; 1.0% losing body weight; 20.8% gaining body weight; and 6.5% stable obese. A total of 320 individuals (2.9%) developed incident gout within the 10 years prior to NHANES participation. Compared with study participants in the stable non-obese group, those in the stable obese group had a significantly higher risk (hazard ratio [HR], 1.84; 95% CI, 1.08-3.14) of developing gout in adulthood during the 10-year follow-up. In addition, individuals who gained weight between young adulthood and midlife were also at increased risk for gout (HR, 1.65; 95% CI, 1.19-2.29). However, no substantial risk differences were observed between individuals who reported losing weight and those in the stable non-obese group.

Researchers also used the population attributable fraction (PAF) to assess the contribution of each BMI trajectory to excess gout risk. According to PAF calculations, maintenance of a normal BMI between young adulthood and obesity could prevent up to 32.9% (95% CI, 18.2%-44.9%) of gout cases.

However, the use of self-report weight and height measurements — instead of medical records data — may have affected the reliability of these estimates. In addition, incident gout was determined by self-report rather than with diagnostic codes, which may have led to an underestimate of its prevalence.

“[These] findings support that maintaining normal weight over the whole of adulthood…reduces the risk [for] gout among obese individuals,” the researchers wrote. “Identifying populations at risk of developing gout may provide opportunities for primary prevention. Clinical trials on long-term health consequences of weight intervention are warranted.”


Bai L, Zhou J-B, Zhou T, Newson RB, Cardoso MA. Incident gout and weight change patterns: a retrospective cohort study of US adults. Arthritis Res Ther. 2021;23(1):69. doi:10.1186/s13075-021-02461-7