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.
Epidemiology of gout in women: Fifty-two–year followup of a prospective cohort
Article first published online: 21 JAN 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 62, Issue 4, pages 1069–1076, April 2010
How to Cite
Bhole, V., de Vera, M., Rahman, M. M., Krishnan, E. and Choi, H. (2010), Epidemiology of gout in women: Fifty-two–year followup of a prospective cohort. Arthritis & Rheumatism, 62: 1069–1076. doi: 10.1002/art.27338
- Issue published online: 30 MAR 2010
- Article first published online: 21 JAN 2010
- Accepted manuscript online: 21 JAN 2010 12:00AM EST
- Manuscript Accepted: 21 DEC 2009
- Manuscript Received: 20 AUG 2009
- NIH. Grant Number: AR-047785
- Canadian Arthritis Network/The Arthritis Society of Canada
- Michael Smith Foundation for Health Research
- Canadian Institutes of Health Research
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.
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.
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.
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.