MADRID — Weight loss may benefit overweight or obese patients with gout, according to findings presented at the EULAR Annual Congress.
Sabrina M. Nielsen, of the Parker Institute, Bispebjerg and Frederiksberg Hospital, suggested that close to half of patients with gout in Europe are overweight.
“BMI is strongly correlated with serum uric acid,” she said. “Weight loss is commonly recommended but, to our knowledge, no one has conducted a systematic review.”
The group aimed to determine the benefits and potential harms associated with weight loss. They conducted a review of databases and other published literature for longitudinal analyses in which weight loss was quantified. The studies also included factors such as joint pain, physical function and health-related quality of life. The analysis included a total of 907 patients from 10 studies.
Several weight management strategies were observed in the studies, from diet with or without physical activity, bariatric surgery, diuretics, metformin or no intervention.
“Some studies dealt with weight loss as associated with a high-protein or low-purine diet,” Nielsen said. “Other studies stratified weight change and no change for comparison.”
Nielsen acknowledged heterogeneity of the data sets, as follow-up ranged from 4 weeks to 7 years.
Results indicated change in serum uric acid ranged from -168 μmol/L to 30 μmol/L. Zero to 60% of patients reached normalization of serum uric acid levels, which the researchers defined as less than 360 μmol/L. Two studies revealed a dose-response relationship for serum uric acid level, serum uric acid level normalization and gout attacks.
“Six out of eight studies showed a beneficial impact on gout attacks,” Nielsen said. “Almost all studies reported beneficial effects of weight loss.”
Positive impacts were also reported with bariatric surgery.
“However, the quality of evidence ranged from low to moderate,” Nielsen concluded. She added there is an urgent need for randomized clinical trials to investigate associations between weight loss and gout. — by Rob Volansky
Nielsen SM, et al. Abstract #OP0340. Presented at: EULAR Annual Congress; June 14-17, 2017; Madrid.
Disclosure: Nielsen reports no relevant financial disclosures.