ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2073

Predictors for Clinically Diagnosed Gout – Results from 30 Years Follow-up of the Malmö Preventive Project Cohort in Southern Sweden

Meliha C. Kapetanovic1, Peter M Nilsson2, Carl Turesson3, Nicola Dalbeth4, Martin Englund5, Lieke E.J.M. Scheepers6 and Lennart TH Jacobsson6, 1Lund University, Skane University Hospital, Department of Rheumatology, Lund, Sweden, Lund, Sweden, 2Department of Clinical Sciences, Lund University, Skåne University Hospital Malmö, Sweden., Lund, Sweden, 3Department of Rheumatology, Skåne University Hospital, Malmö, Sweden, 4University of Auckland, Auckland, New Zealand, 5Clinical Sciences Lund, Orthopedics, Clinical Epidemiology Unit, Lund University, Lund, Sweden, 6Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: ,

Session Information

Date: Tuesday, November 7, 2017

Title: Metabolic and Crystal Arthropathies Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Gout is the most common form of arthritis worldwide. Hyperuricemia is a crucial risk factor resulting in accumulation of uric acid (s-UA) crystals in tissues and in a subset development of clinical gout. The relative importance of other risk factors, some of which are associated with s-UA levels, is slightly more controversial. The aim of this preliminary analysis, were to identify such predictors for clinical gout in a population survey, the Malmö Preventive Project (MPP)- a large-scale screening and case-finding program for cardiovascular risk factors, alcohol abuse and breast cancer in the city of Malmö, Sweden.

Methods: Overall, 33.346 individuals (67% male, mean age 45.7 years at inclusion, mean follow up 28.2 years) participated. The study population was screened between 1974 and 1992. A baseline health screening included: 1. Questionnaire with 260 questions (socioeconomic factors, alcohol consumption, smoking, physical activity, dietary habits, history of gout and other co-morbidities) 2. Physical examination (including weight, height, BMI, and blood pressure) and 3. Laboratory tests (serum urate, fasting glucose, s-creatinine). Endpoint was defined as the date of first gout diagnosis, death, moving from the area, or December 31st 2014. In order to identify all gout diagnoses (using ICD-codes) given at visits to physicians in primary care, in specialized in-patient (from 1974) and out-patient specialized care (from 2001); MPP cohort was linked to reginal health care register and to the national patient register, respectively. Individuals with a history of gout before the inclusion in MPP (n=11) were excluded from the analysis. Possible baseline predictors of developing gout were analysed using Cox-regression model.

Results: Of 33.346 individuals participating in MPM project, 1275 (3.8%) were diagnosed with clinically gout over 30 years follow up. Subjects with higher s-UA at baseline (age- and sex-adjusted) had a significantly increased risk of developing gout. In addition, results from the multivariate analysis identified higher age, male sex, higher baseline BMI, systolic blood pressure, current smoking for ≥ 10 years and daily alcohol drinking as independent predictors of incident gout (Table).

Conclusion: In addition to hyperuricemia, increased age, male sex, hypertriglyceridemia, concomitant hypertension, smoking and daily drinking were independent predictors for development of gout in this large cohort of middle-aged individuals.

Table: Baseline predictors of development of gout over 30 years

Mean (SD)

HR (95% CI) (age/sex adjusted)

HR (95% CI)*

(multivariate analysis)

Age

45.7 (7.4)

1.5 (1.4-1.6)

1.4 (1.3-1.6)

s-UA (µmol/L)

300.8 (70.1)

2.0 (1.9-2.0)

1.8 (1.8-1.9)

s-creatinine (µmol/L)

87.6 (18.7)

1.1 (1.0-1.1)

1.0 (1.0-1.1)

BMI (kg/m2)

24.6 (3.6)

1.5 (1.4-1.6)

1.3 (1.2-1.3)

s-glucose (mmol/L)

4.97 (1.0)

1.1 (1.1-1.2)

0.8 (0.7-0.9)

s-cholesterol (mmol/L)

5.7 (1.1)

1.2 (1.1-1.2)

1.1 (1.0-1.1)

s-triglycerides(mmol/L)

1.4 (0.9)

1.1(1.1-1.2)

1.1 (1.0-1.1)

Systolic blood pressure (mm Hg)

129.8 (17.1)

1.3 (1.3-1.4)

1.2 (1.1-1.2)

Sex (% male)

67.3%

1.7 (1.4-1.9)

1.4 (1.2-1.7)

Daily alcohol drinking (yes/no)

0.7%

1.8 (1.1-3.1)

1.4 (1.1-1.9)

Smoking for >10 years (yes/no)

53.1%

1.3 (1.1-1.4)

1.3 (1.2-1.5)

Treatment for hypertension (yes/no)

2.2%

1.9 (1.4-2.6)

1.1 (0.9-1.4)

Treatment with diuretics (yes/no)

0.6%

1.4 (0.8-2.7)

0.8 (0.6-1.2)

*HR is calculated per 1 SD or for dichotomous covariates (yes vs. no).

Disclosure: M. C. Kapetanovic, None; P. M. Nilsson, None; C. Turesson, None; N. Dalbeth, Abbott Laboratories, 8; M. Englund, None; L. E. J. M. Scheepers, None; L. T. Jacobsson, Abbvie, Celegen, MSD, Novartis and UCB, 5.

To cite this abstract in AMA style:

Kapetanovic MC, Nilsson PM, Turesson C, Dalbeth N, Englund M, Scheepers LEJM, Jacobsson LT. Predictors for Clinically Diagnosed Gout – Results from 30 Years Follow-up of the Malmö Preventive Project Cohort in Southern Sweden [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/predictors-for-clinically-diagnosed-gout-results-from-30-years-follow-up-of-the-malmo-preventive-project-cohort-in-southern-sweden/. Accessed .

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/predictors-for-clinically-diagnosed-gout-results-from-30-years-follow-up-of-the-malmo-preventive-project-cohort-in-southern-sweden/