Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
A Comparison of Traditional Gout Risk Factors Between Men and Women in the Atherosclerosis Risk in Communities (ARIC) Study
Maynard1, Janet W., McAdams2, Mara A., Baer1, Alan N., Kottgen2, Anna, Gelber1, Allan C., Coresh2, Josef
Johns Hopkins University School of Medicine, Baltimore, MD
Johns Hopkins School of Public Health, Baltimore, MD
Purpose:
Gout is a major form of inflammatory arthritis in both men and women; yet, little is known about whether clinical risk factors for gout vary by gender. In the Atherosclerosis Risk in Communities (ARIC) Study, we evaluated the association of traditional risk factors for gout in women as compared to men.
Methods:
ARIC is a population-based cohort study of 15,792 individuals (55% women) recruited in 1987–1989. Our study population consisted of African-American and Caucasian men and women with and without gout. A participant was considered to have gout if 1 or more of the following criteria were met: a) gout was self-reported, b) surveillance of hospital discharge summaries revealed an ICD-9 code for gout (274.0, 274.1, 274.8, or 274.9), or c) use of a medication taken primarily to treat gout at any study visit. We stratified by gender and used multivariable logistic regression to model the risk of prevalent gout. The multivariable models included baseline age, race, obesity, organ meat, animal protein, shellfish, and alcohol intake, diuretic use, hypertension, renal function, and diabetes. Obesity was classified as BMI >30. We generated models using interaction terms to see if gender modifies the relationship between traditional risk factors and gout.
Results:
399 women (4.8%) and 703 men (9.9%) have gout in the ARIC cohort. In women and men, African-American race, obesity, high alcohol intake, hypertension, and decreased kidney function were associated with an increased risk of gout. In women, but not in men, age and organ meat intake were associated with an increased risk of gout. In men, but not in women, diabetes was associated with an increased risk of gout. Gender modified the relationship between gout and three traditional risk factors: race, protein intake, and organ meat intake.
| Women OR (95% CI) | Men OR (95% CI) | P-value for interaction of gender | |
|---|---|---|---|
| Age (per 1 year) | 1.04 (1.02, 1.07) | 1.01 (0.99, 1.03) | 0.07 |
| Race | |||
| Caucasian (reference) | 1 | 1 | |
| African-American | 1.87 (1.46, 2.40) | 1.47 (1.20, 1.80) | 0.05 |
| Obesity | 2.43 (1.93, 3.06) | 1.98 (1.66, 2.37) | 0.07 |
| Protein (per 15gm) | 1.05 (0.98, 1.13) | 0.94 (0.89, 0.99) | 0.005 |
| Shellfish | 0.99 (0.79, 1.25) | 1.05 (0.89, 1.25) | 0.96 |
| Organ Meat | 1.28 (1.02, 1.61) | 0.85 (0.72, 1.02) | 0.002 |
| Alcohol | |||
| No drinks/day (reference) | 1 | 1 | |
| 1–2 drinks/day | 0.98 (0.74, 1.32) | 1.24 (1.03, 1.50) | 0.36 |
| >2 drinks/day | 2.01 (1.08, 3.72) | 2.30 (1.82, 2.89) | 0.86 |
| Diuretic use | 1.60 (1.22, 2.10) | 1.44 (1.14, 1.80) | 0.87 |
| Hypertension | 1.71 (1.29, 2.27) | 2.34 (1.91, 2.86) | 0.44 |
| Kidney function (per 10 mls/min/1.73m2) | 0.84 (0.77, 0.92) | 0.77 (0.72, 0.83) | 0.08 |
| Diabetes | 1.21 (0.92, 1.59) | 1.33 (1.06, 1.67) | 0.86 |
| Key: OR=odds ratio; CI=confidence interval | |||
Conclusion:
Traditional risk factors, including African-American race, obesity, high alcohol intake, diuretic use, decreased kidney function and hypertension are associated with an increased risk of gout in both women and men. The relationship between certain risk factors, such as African-American race, protein intake, and organ meat intake varies by gender. Understanding how gender modifies traditional risk factors may allow for more targeted patient counseling and treatment strategies.
To cite this abstract, please use the following information:
Maynard, Janet W., McAdams, Mara A., Baer, Alan N., Kottgen, Anna, Gelber, Allan C., Coresh, Josef; A Comparison of Traditional Gout Risk Factors Between Men and Women in the Atherosclerosis Risk in Communities (ARIC) Study [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1391
DOI: 10.1002/art.26465
