ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2661

Physical Activity, Adiposity, and The Risk Of Gout In Women: The Nurses Health Study

Hyon Choi1,2,3, Lindsay C Burns4,5, Yuqing Zhang6, Sharan Rai1 and Gary Curhan7, 1Arthritis Research Centre of Canada, Richmond, BC, Canada, 2Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, 3Division of Rheumatology, Allergy, and Immunology Massachusetts General Hospital, Harvard Medical School, Boston, MA, 4Research, Arthritis Research Centre of Canada, Richmond, BC, Canada, 5Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada, 6Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA, 7German Research Center for Environmental Health, Harvard Medical School, Boston, MA

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: , , ,

Session Information

Title: Epidemiology and Health Services Research VI: Risk Factors in Rheumatic Disease Susceptibility

Session Type: Abstract Submissions (ACR)

Background/Purpose: There is a remarkable, increasing disease burden of gout and its associated cardiovascular (CV)-metabolic comorbidities in the US.  While the benefits of physical exercise on CV-metabolic outcomes have been shown to extend beyond weight loss, such an independent impact on the risk of gout is unknown.  We evaluated the potential impact of physical activity on the risk of incident gout in a large prospective cohort of women in the Nurses Health Study.

Methods: We examined the relation between physical activity, body mass index, and the risk of incident gout in 94,389 female participants with no history of gout at baseline.  We used the American College of Rheumatology criteria to ascertain gout.  Cox proportional hazards models were used to estimate the relative risk (RR) of incident gout after adjusting for the following variables in a time-varying manner: age, total energy intake, alcohol, body-mass index, use of diuretics, history of hypertension, history of chronic renal failure, and daily mean intake of meats, seafood, dairy foods, coffee, and total vitamin C.

Results: During 26 years of follow-up, we documented 846 confirmed incident cases of gout.  An increasing level of physical activity was independently associated with a decreasing risk of gout.  The multivariate relative risks (RRs) of gout were 1.00, 0.99, 0.90, 0.81, and 0.75 (95% CI, 0.58 to 0.97) (P for trend < 0.001) for physical activity levels from the lowest to the highest quintile (Table).  In contrast, compared with BMI < 21, the multivariate RRs of gout were 1.71, 1.81, 2.91, 5.00, 6.77 (95% CI, 4.60 to 10.0) (P for trend < 0.001) for BMI categories of 21-22.9, 23-24.9, 25-29.9, 30-34.9, and ≥35, respectively.  These findings persisted in subgroup analyses stratified by major factors such as intake of alcohol, dairy products, and sugary soda (all P values for interaction > 0.05).

Conclusion: Our findings provide prospective evidence that increased physical activity is independently associated with a decreased risk of incident gout among women, beyond its impact on adiposity.  In contrast, increased adiposity was independently associated with an increased risk of incident gout.  These findings support the fundamental role of increased physical activity and weight control in the prevention of gout.

 

Table 1. Relative Risk of Incident Gout According to Physical Activity

Physical Activity (hr/wk) 0 0.03-0.50 0.51-1.50 1.51-3.74 ≥3.75   P for trend
<>No. of Cases

249

257

104

138

98

 

–

Person-Years

394096

251287

315926

299321

318665

 

–

Age-Adjusted RR (95% CI)

1.0

0.84

(0.66, 1.08)

0.70

(0.57, 0.86)

0.56

(0.44, 0.71)

0.44

(0.34, 0.56)

 

< 0.001

Multivariate* RR (95% CI)

1.0

0.94

(0.74, 1.20)

0.82

(0.67, 1.01)

0.70

(0.55, 0.89)

0.59

(0.46, 0.76)

 

< 0.001

Multivariate* + BMI-adjusted RR (95% CI)

1.0

0.99

(0.78, 1.26)

0.90

(0.73, 1.11)

0.81

(0.64, 1.03)

0.75

(0.58, 0.97)

 

0.012

Table 2. Relative Risk of Incident Gout According to BMI

<>Body Mass Index (kg/m2) <21 21-22.9 23-24.9 25-29.9 30-34.9 ≥35 P for trend
<>No. of Cases

33

75

99

304

248

173

–

Person-Years

322346

419510

441973

678320

262748

120362

–

Age Adjusted RR (95% CI)

1.0

1.80

(1.20, 2.71)

2.07

(1.40, 3.08)

3.80

(2.65, 5.45)

7.81

(5.42, 11.2)

12.8

(8.83, 18.7)

< 0.001

Multivariate RR (95% CI)*

1.0

1.70

(1.13, 2.57)

1.82

(1.22, 2.70)

2.94

(2.05, 4.23)

5.14

(3.55, 7.45)

7.07

(4.81, 10.4)

< 0.001

Multivariate*+ Physical Activity-adjusted RR (95% CI)

1.0

1.71

(1.13, 2.58)

1.81

(1.22, 2.69)

2.91

(2.02, 4.18)

5.00

(3.45, 7.26)

6.77

(4.60, 10.0)

< 0.001

Abbreviations: RR= Relative Risk; CI = confidence intervals

*Adjusted for age, total energy intake, menopause, use of hormonal replacement, diuretic use, history of hypertension, and intake of alcohol, sugar-sweetened soft drinks, coffee, total meats, seafood, dairy foods, and total vitamin C

 

Disclosure:

H. Choi,
None;

L. C. Burns,
None;

Y. Zhang,
None;

S. Rai,
None;

G. Curhan,
None.

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