medwireNews: The metabolic syndrome (MetS) may be a modifiable risk factor for incident gout, suggest findings from a nationwide study of more than 1.29 million men.
In all, 18,473 of the total study cohort, aged an average of 33.2 years, were newly diagnosed with gout, at an incidence rate of 3.36 per 1000 person–years.
And the results showed that for 69,091 men who had MetS at three routine health checkups at 2-year intervals, the risk for gout was 3.82-fold greater than for 1,108,840 men who were free of MetS at all three checkups.
This association between MetS and risk for gout was most marked among men in their 20s, compared with their 30s, and in men who were underweight or of a healthy weight compared with overweight, the investigators note.
MetS was defined by the presence of three or more of its components, which comprise abdominal obesity (waist circumference ≥90 cm); elevated triglyceride levels (≥150 mg/dL); reduced high-density lipoprotein cholesterol (<40 mg/dL); elevated blood pressure (BP; systolic BP ≥130 mmHg and/or diastolic BP ≥85 mmHg); and elevated fasting glucose (≥100 mg/dL).
Jaejoon Lee (Sungkyunkwan University School of Medicine, Seoul, South Korea) and colleagues stress in Arthritis & Rheumatology that “the change in the status of MetS affected the risk of future gout development.”
They found that the risk for gout was increased more than twofold among 58,287 individuals who developed MetS after the first checkup, compared with men without MetS, after taking into account age, smoking status, alcohol intake, regular exercise, income, and the number of MetS components at baseline. And it was reduced by nearly half among the 56,948 men who had MetS only at the first checkup and then recovered, compared with men who had MetS at all three checkups.
“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,” say the researchers.
Indeed, they note that a “decrease in the number of MetS components [was] associated with a decrease in the risk of incident gout,” which “suggests that MetS is a modifiable risk factor of gout.”
Of the various MetS components, reductions in abdominal obesity and elevated triglyceride levels “had the greatest influence on risk of incident gout,” the team reports.
Lee and co-authors conclude that “[f]uture interventional studies are warranted to confirm the protective role of MetS recovery on gout.”
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Arthritis Rheumatol 2022; doi:10.1002/art.42381