Special Theme Articles: Obesity and the Rheumatic Diseases
Body mass index, obesity, and prevalent gout in the United States in 1988–1994 and 2007–2010
Version of Record online: 27 DEC 2012
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 1, pages 127–132, January 2013
How to Cite
Juraschek, S. P., Miller, E. R. and Gelber, A. C. (2013), Body mass index, obesity, and prevalent gout in the United States in 1988–1994 and 2007–2010. Arthritis Care Res, 65: 127–132. doi: 10.1002/acr.21791
- Issue online: 27 DEC 2012
- Version of Record online: 27 DEC 2012
- Accepted manuscript online: 6 JUL 2012 02:50PM EST
- Manuscript Accepted: 22 JUN 2012
- Manuscript Received: 31 JAN 2012
- NIH/National Heart, Lung, and Blood Institute Cardiovascular Epidemiology Training Grant. Grant Number: T32-HL-007024
- Donald B. and Dorothy Stabler Foundation
To determine the association and prevalence of gout among overweight, obese, and morbidly obese segments of the US population.
Among participants (age ≥20 years) of the National Health and Nutrition Examination Surveys in 1988–1994 and 2007–2010, gout status was ascertained by self-report of a physician diagnosis. Body mass index (BMI) was examined in categories of <18.5 kg/m2, 18.5–24.9 kg/m2, 25–29.9 kg/m2, 30–34.9 kg/m2, and ≥35 kg/m2 and as a continuous variable. The cross-sectional association of BMI category with gout status was adjusted for demographic and obesity-related medical disorders.
In the US, the crude prevalence of gout was 1–2% among participants with a normal BMI (18.5–24.9 kg/m2), 3% among overweight participants, 4–5% with class I obesity, and 5–7% with class II or class III obesity. The adjusted prevalence ratio comparing the highest to a normal BMI category was 2.46 (95% confidence interval [95% CI] 1.44–4.21) in 1988–1994 and 2.21 (95% CI 1.50–3.26) in 2007–2010. Notably, there was a progressively greater prevalence ratio of gout associated with successively higher categories of BMI. In both survey periods, for an average American adult standing 1.76 meters (5 feet 9 inches), a 1-unit higher BMI, corresponding to 3.1 kg (∼6.8 pounds) greater weight, was associated with a 5% greater prevalence of gout, even after adjusting for serum uric acid (P < 0.001).
Health care providers should be aware of the elevated burden of gout among both overweight and obese adults, applicable to both women and men, and observed among non-Hispanic whites, non-Hispanic African Americans, and Mexican Americans in the US.