Disclosures: The researchers report funding support from the National Natural Science Foundation of China, Beijing Municipal Administration of Hospital’s Youth Program, Excellent Talents in Dongcheng District of Beijing.
March 15, 2021
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Midlife weight gain, persistent obesity raise risk for gout

Disclosures: The researchers report funding support from the National Natural Science Foundation of China, Beijing Municipal Administration of Hospital’s Youth Program, Excellent Talents in Dongcheng District of Beijing.
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Weight gain from early adulthood to midlife, as well as consistent obesity throughout adulthood, were associated with an increased risk for gout, according to data published in Arthritis Research & Therapy.

“Although some prospective studies have clarified the relationship between obesity and the incidence of gout, the influence of weight changes during the transition from early adulthood to midlife and the different weight change patterns in specific age ranges on the incidence of gout in later life remain unknown,” Jian-Bo Zhou, PhD, of Beijing Tongren Hospital, at Capital Medical University, in Beijing, China, and colleagues wrote. “Hence, assessment of the population-level effect of weight change across the life course on incident gout risk is needed.”

“We found that being obese in any life stage would increase the risk of incident gout,” Jian-Bo Zhou, PhD, told Healio Rheumatology, noting that the study focused on tracking weight change rather than weight at a single point in time. Data derived from Bai L, et al. Arthritis Res Ther. 2021;doi:10.1186/s13075-021-02461-7.

To analyze the link between changes in weight through adulthood and gout, Zhou and colleagues conducted a retrospective, longitudinal study using national U.S. data from the National Health and Nutrition Examination Survey (NHANES). This survey includes data on demographics, weight history and health behaviors from a nationally representative sample of U.S. adults. For their own study, the researchers included information on 11,079 adults aged 40 to 70 years who participated in NHANES from 2007 to 2014.

Zhou and colleagues grouped the included adults into one of four weight categories, based on participants’ self-reported recollections of their weight at age 25 years and 10 years prior to the survey. Those who remained obese throughout the study period were identified as “stable obese,” those whose BMI shifted from non-obese to obese were “gaining,” those who shifted from obese to non-obese were “losing,” and adults who remained non-obese were labeled “stable non-obese.” Incident gout was defined as any occurrence during the 10-year follow-up period from the recalled midlife weight measure to the time of the survey.

The researchers used Cox models to determine hazard ratios and confidence intervals for the association between weight change and incident gout during the 10-year follow-up, adjusted for covariates. They also calculated the hypothetical population attributable fraction for the weight change patterns.

“Our study is a specially designed retrospective study that represents a new way of thinking for me,” Zhou told Healio Rheumatology. “Firstly, we used recalled weight and height to form data. Secondly, we focused on tracking weight change [rather than] a single [time] point of weight.”

According to the researchers, 320 of the included adults developed gout. Individuals classified as stable obese demonstrated the highest risk for incident gout (HR = 1.84; 95% CI, 1.08-3.14). Weight gain was also a significant risk factor for incident gout (HR = 1.65; 95% CI, 1.19-2.29). There were no significant links between weight loss and the risk for gout.

The researchers estimated that about 3.2% (95% CI, 0-6.3) of the observed gout cases could have been avoided had those who gained weight shifted to a non-obese BMI during the 10-year follow-up period. They additionally determined that 32.9% (95% CI, 18.2-44.9) of cases could have been prevented had the population had maintained a normal BMI during those 10years.

“We found that being obese in any life stage would increase the risk of incident gout,” Zhou said. “It’s said that you are what you eat, which means one’s experience would leave a mark on the body. Do not stick to a single point [in time], but try to connect different dots that happened in [the patient’s] life and sometimes it will predict the future.”