Hibah Khaja, PharmD | January 17, 2024
Anthropometric measures remained stable over a 2-year period among patients actively treated for gout, while lipid levels showed a decrease. After 2 years, high waist circumference and lipid levels were associated with unfavorable gout outcomes.Anthropometric measures remained stable over a 2-year period among patients actively treated for gout, while lipid levels showed a decrease. After 2 years, high waist circumference (WC) and lipid levels were associated with unfavorable gout outcomes, according to study results published in Rheumatic & Musculoskeletal Diseases Open.
In a prospective observational study including patients in Norway being actively treated for gout, researchers examined transformations in anthropometric measures and lipid levels over 2 years and assessed their predictive value for gout outcomes.
During the first year, patients received treat-to-target urate-lowering therapy with allopurinol or febuxostat.
Patients self-reported specific lifestyle factors, including smoking, alcohol and sugar-sweetened drinks consumption, and physical activity at baseline.
Our findings give further support to recommended lifestyle changes in patients with gout, but more research is needed on the role of lipids in gout, and on the best provision of education to these patients.
Anthropometric factors, including body mass index (BMI), WC, and waist-hip ratio (WHR), were measured at baseline, year 1, and year 2.
Gout outcomes assessed included baseline tophaceous disease, achievement of serum urate (sUA) target levels (<360 μmol/L) at year 2, and flare occurrence during year 2.
A total of 211 patients were included in the final analysis; among these, the majority (95%) were men, and the mean patient age was 56 (SD, 13.7) years.
After the treat-to-target period in year 1, a significant proportion of patients (85.5%) successfully achieved sUA target levels. However, this percentage slightly declined to 78.6% by year 2.
During the course of 2 years, minimal changes were observed in anthropometric measures. Although mean BMI statistically significantly increased from 28.78 to 29.16 kg/m2 (P=.018), this trend was not observed for WC and WHR.
At baseline, individuals with tophus were generally older, had longer disease duration, increased creatinine, and lower estimated glomerular filtration rates. Additionally, tophi were linked to greater WC and WHR.
Achievement of sUA target levels at year 2 was less likely among patients with higher baseline WC (odds ratio [OR], 0.96 per cm; 95% CI, 0.93-0.99) but more likely among those with increased levels of high-density lipoprotein cholesterol (OR, 5.1 per mmol/L; 95% CI, 1.2-22.1).
Additionally, gout flare occurrence during year 2 was predicted by high low-density lipoprotein cholesterol levels (OR, 1.8 per mmol/L; 95% CI, 1.2-2.6).
Study findings may be limited by the absence of a control population and the utilization of an observational study design, which prevented the establishment of causal relationships.
Study authors concluded, “Our findings give further support to recommended lifestyle changes in patients with gout, but more research is needed on the role of lipids in gout, and on the best provision of education to these patients.”
Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
References:
Uhlig T, Karoliussen LF, Sexton J, Kvien TK, Haavardsholm EA, Hammer HB. Lifestyle factors predict gout outcomes: results from the NOR-Gout longitudinal 2-year treat-to-target study. RMD Open. Published online December 1, 2023. doi:10.1136/rmdopen-2023-003600
