Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Racial Differences in Gout Risk and Uric Acid Levels in Both Men and Women in the Atherosclerosis Risk in Communities (ARIC) Study.

W. Maynard,  Janet, A. McAdams,  Mara, N. Baer,  Alan, C. Gelber,  Allan, Coresh,  Josef

Purpose:

Gout is a common form of inflammatory arthritis; yet, few studies have evaluated the relationship between race and gout in both women and men. We evaluated the association of race with gout and uric acid levels in the Atherosclerosis Risk in Communities (ARIC) Study, a large population-based and racially-diverse cohort.

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) the participant reported use of a medication taken primarily to treat gout (allopurinol, colchicine, or probenecid) at any study visit. The distributions of baseline variables among the men with gout versus those without gout were compared using chi-squared or t-tests, as appropriate. We stratified by gender and used multivariate logistic regression to model the association of race and prevalent gout. The multivariate models included baseline age, BMI, protein, organ meat, shellfish, and alcohol intake, hypertension, antihypertensive medication use, income, education, tobacco use, diabetes, and renal function. Lastly, we generated a multivariate model with the previously mentioned confounders and uric acid.

Results:

399 women (4.6%) and 702 men (9.9%) had gout in the ARIC cohort. In both men and women, a significantly higher proportion of African-Americans had gout (p<0.001). After stratifying by gender, the mean serum uric acid level was higher in African-Americans compared to Caucasians (p<0.001 in women and men). The mean difference in uric acid levels for African-Americans versus Caucasians was 0.57 mg/dL (0.50, 0.64) in women and 0.31 mg/dL (0.22, 0.40) in men. African-American race was associated with an increased risk of gout even after adjusting for known confounders in both men and women (Table). However, after further adjustment for uric acid levels at baseline, the effect was not statistically significant.

Table. Association of Race with Gout in the Atherosclerosis Risk in Communities (ARIC) Study.

 CaucasiansAfrican-Americans
Women  
Gout cases, n (%)203 (3.4)196 (7.4)
Uric acid level (mg/dL) (mean ± SD)5.3 ± 1.45.9 ± 1.5
Age-adjusted OR (95% CI)1.00 (Ref)2.42 (1.97, 2.96)
Multivariate OR (95% CI)1.00 (Ref)1.57 (1.17, 2.10)
Multivariate Model including uric acid OR (95% CI)1.00 (Ref)1.34 (0.99, 1.80)
Men  
Gout cases, n (%)490 (9.0)212 (13.0)
Uric acid level (mg/dL) (mean ± SD)6.7 ± 1.37.0 ± 1.6
Age-adjusted OR (95% CI)1.00 (Ref)1.55 (1.31, 1.85)
Multivariate OR (95% CI)1.00 (Ref)1.42 (1.12, 1.79)
Multivariate Model including uric acid OR (95% CI)1.00 (Ref)0.99 (0.77, 1.27)
Key: OR=odds ratio; CI=confidence interval

Conclusions:

African-American race is associated with a greater than 50% increase risk of gout in both men and women, even after adjustment for known confounders. This suggests that above and beyond differential prevalence of medical comorbidities, including hypertension, race increases gout risk. This increased gout risk may be mediated by higher uric acid levels in African-Americans compared to Caucasians.

To cite this abstract, please use the following information:
W. Maynard, Janet, A. McAdams, Mara, N. Baer, Alan, C. Gelber, Allan, Coresh, Josef; Racial Differences in Gout Risk and Uric Acid Levels in Both Men and Women in the Atherosclerosis Risk in Communities (ARIC) Study. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1556
DOI: 10.1002/art.29322

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