Association between serum urate, gout and comorbidities: a case–control study using data from the UK Biobank

Sandoval-Plata, Gabriela; Nakafero, Georgina; Chakravorty, Mithun; Morgan, Kevin; Abhishek, Abhishek

Abstract

Objectives To examine the association between comorbidities and serum urate (SU), gout and comorbidities, and to determine whether the association between gout and comorbidities is independent of SU. Methods We performed a case-control study using UK Biobank data. Two separate analyses were conducted: one excluding participants with gout to investigate the association between comorbidities and SU and the other with participants with gout as the index condition to examine the association between gout and comorbidities. SU was measured at the baseline visit. Self-reported physician-diagnosed illnesses were used to define gout and comorbidities, except for chronic kidney disease (CKD), which was defined using an estimated glomerular filtration rate cut-off. Participants prescribed urate-lowering treatment were also classified as gout. Logistic regression was used to examine associations. Odds ratios (ORs) and 95% CIs were calculated and adjusted for covariates including comorbidities and SU. Results Data for 458 781 UK Biobank participants were used to examine the association between comorbidities and SU. There was an association between hypertension, ischaemic heart disease (IHD), congestive cardiac failure (CCF), hyperlipidaemia, CKD and SU with and adjusted OR (aOR) of 1.10-3.14 for each 1 mg/dl SU increase. A total of 10 265 gout cases and 458 781 controls were included in the analysis of association between gout and comorbidities. Gout associated independently with hypertension, IHD, CCF, hyperlipidaemia and diabetes, with aORs of 1.21-4.15 after adjusting for covariates including SU. Conclusion Comorbidities associate with increasing SU. The association between gout and cardiometabolic comorbidities was independent of SU, suggesting separate SU-independent mechanisms such as inflammation driven by crystal deposition, pro-inflammatory genotype or non-purine dietary factors.

Citation

Sandoval-Plata, G., Nakafero, G., Chakravorty, M., Morgan, K., & Abhishek, A. (2021). Association between serum urate, gout and comorbidities: a case–control study using data from the UK Biobank. Rheumatology, 60(7), 3243-3251. https://doi.org/10.1093/rheumatology/keaa773

• Journal Article Type: Article
• Acceptance Date: Sep 22, 2020
• Online Publication Date: Dec 13, 2020
• Publication Date: Jul 1, 2021
• Deposit Date: Nov 20, 2020
• Publicly Available Date: Dec 14, 2021
• Journal: Rheumatology
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 60
• Issue: 7
• Pages: 3243-3251
• DOI: https://doi.org/10.1093/rheumatology/keaa773
• Keywords: Crystal induced arthritis; gout; cardiovascular comorbidities; hyperuricaemia.
• Public URL: https://nottingham-repository.worktribe.com/output/5055695
• Publisher URL: https://academic.oup.com/rheumatology/article-abstract/60/7/3243/6032841?redirectedFrom=fulltext
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record, Gabriela Sandoval-Plata, Georgina Nakafero, Mithun Chakravorty, Kevin Morgan, Abhishek Abhishek, Association between serum urate, gout and comorbidities: a case–control study using data from the UK Biobank, Rheumatology, , keaa773, is available online at: https://academic.oup.com/rheumatology/article-abstract/60/7/3243/6032841?redirectedFrom=fulltext