Epidemiology of gout in women: Fifty-two–year followup of a prospective cohort

Authors

  • Vidula Bhole,

    1. Boston University School of Medicine, Boston, Massachusetts
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  • Mary de Vera,

    1. Boston University School of Medicine, Boston, Massachusetts
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  • M. Mushfiqur Rahman,

    1. Boston University School of Medicine, Boston, Massachusetts
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  • Eswar Krishnan,

    1. Boston University School of Medicine, Boston, Massachusetts
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    • Dr. Krishnan has received consulting fees, speaking fees, and/or honoraria from Savient Pharmaceuticals and UCB Pharma (less than $10,000 each) and from Takeda Pharmaceuticals (more than $10,000); he has served as a paid consultant to Cowan and Associates.

  • Hyon Choi

    Corresponding author
    1. Boston University School of Medicine, Boston, Massachusetts
    • Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Suite 200, Boston, MA 02118
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    • Dr. Choi has received honoraria for service on the Savient Pharmaceuticals advisory board (less than $10,000) and on the TAP Pharmaceuticals advisory board (more than $10,000).


Abstract

Objective

Despite the recent doubling of the incidence of gout among women and its substantial prevalence particularly in the aging female population, the risk factors for gout among women remain unknown. We undertook this study to evaluate purported risk factors for incident gout among women and to compare them with those among men.

Methods

Using prospective data from the Framingham Heart Study, we examined over a 52-year period (1950–2002) the relationship between purported risk factors and the incidence of gout in 2,476 women and 1,951 men.

Results

We documented 304 incident cases of gout, 104 of them among women. The incidence rates of gout for women per 1,000 person-years according to serum uric acid levels of <5.0, 5.0–5.9, 6.0–6.9, 7.0–7.9, and ≥8.0 mg/dl were 0.8, 2.5, 4.2, 13.1, and 27.3, respectively (P for trend < 0.0001). The magnitude of this association was lower than that among men (P for interaction = 0.0002). Multivariate relative risks conferred by increasing age (per 5 years), obesity (body mass index ≥30 kg/m2), alcohol intake (≥7 ounces of pure alcohol/week), hypertension, and diuretic use were 1.24, 2.74, 3.10, 1.82, and 2.39, respectively (all P < 0.05), for women.

Conclusion

These prospective data with long-term followup provide evidence that higher levels of serum uric acid increase the risk of gout in a graded manner among women, but the rate of increase is lower than that among men. Increasing age, obesity, alcohol consumption, hypertension, and diuretic use were associated with the risk of incident gout among women.

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