Background/Purpose: Previous studies have reported that walking is associated with a lower risk of several metabolic diseases; however, evidence of its association with gout, a metabolic condition, is lacking. We aimed to examine the relation of walking volume and intensity to the risk of incident gout.

Methods: Using data from the UK Biobank, a population-based cohort study was conducted to examine the relation of walking volume (total steps), walking intensity (peak 30-minute cadence), and their combination (purposeful steps, defined as average daily steps accumulated at a rate of exceeding 40 steps/minute) to the risk of incident gout. Participants aged 40-70 years, free of gout, and with valid accelerometer data at baseline were included. Hazard ratios (HRs) for incident gout were estimated across different walking activity metrics groups using Cox proportional hazard models, and the dose-response relationship was evaluated using restricted cubic spline regression. Three sensitivity analyses were conducted to assess the robustness of findings: (1) removing the accelerometer wear time from the multivariable adjusted model, (2) excluding incident gout cases within six months after the index date to mitigate potential reverse causation, and (3) restricting gout case confirmation to hospital inpatient records to minimize potential misclassification bias.

Results: Among 92,066 participants included in the current analyses, 706 developed incident gout during a mean follow-up period of 6.93 years. After adjustment for potential covariates, no significant association was observed between total steps or peak 30-minute cadence and the risk of incident gout (Table 1). However, compared with the low group (< 5,000 steps/day) of purposeful steps, the risk of incident gout was lower in the middle group (5,000-7,999 steps/day) and high (≥8,000 steps/day) group, with adjusted HRs and 95% confidence intervals of 0.78 (0.66–0.94) and 0.72 (0.58–0.90), respectively (P for trend =0.003) (Table 2). The associations remained consistent in sensitivity analyses, including when accelerometer wear time was excluded from models, those excluding incident gout cases occurring within the first six months of the index date, and those restricted to hospital-confirmed gout cases. Restricted cubic spline regression revealed significant linear inverse associations between purposeful steps and the risk of incident gout (Figure 1).

Conclusion: This large population-based cohort study demonstrates that higher purposeful steps, defined as the combined measure of walking volume and intensity, are associated with a lower risk of incident gout. These findings provide valuable insights for developing walking-based recommendations to prevent incident gout.

Table 1. Association Between Total Steps and Peak 30-minute Cadence and Risk of Incident Gout

Table 2. Association Between Purposeful Steps and Risk of Incident Gout

Figure 1. Associations Between Walking Activity and Incident Gout. Association between total steps (A), peak 30-minute cadence (B), and purposeful steps (C) and incident gout. Restricted cubic spline regression models fit with three knots placed at the median of three groups of categorical exposures. The y-axis is a log scale with the shaded area representing 95% confidence intervals. Hazard ratios are adjusted for age, sex, deprivation index, alcohol drinking status, coffee intake, red meat intake, poultry intake, fish intake, accelerometer wear time, body mass index, serum creatinine concentration, hyperuricemia, history of hypertension, history of diabetes, diuretic usage, and nonsteroidal anti-inflammatory drug usage at baseline. For total steps, models were further adjusted for peak 30-minute cadence (and vice versa).

« Back to ACR Convergence 2025

ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-of-walking-volume-and-intensity-with-incident-gout-a-population-based-cohort-study/