Session Information
Date: Tuesday, October 23, 2018
Title: Metabolic and Crystal Arthropathies – Basic and Clinical Science Poster II
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Precise estimates of the comorbidity burden of gout and hyperuricemia are critical as their presence has important implications for the treatment of both gout and hyperuricemia. We therefore estimated the decadal US prevalence of cardiovascular-renal-metabolic comorbidities according to gout and hyperuricemia status, based on the National Health and Nutritional Examination Survey (NHANES) 2007-2016.
Methods: Using data from 26,332 participants (12,793 men and 13,539 women) aged ≥20 years old from NHANES 2007-2016, we determined the prevalence (%) of cardiovascular-renal-metabolic comorbidities according to gout and hyperuricemia status. Obesity was defined as body mass index≥30 kg/m2. Other comorbidities were defined based on an affirmative answer to a question asking if a physician or a health professional had diagnosed the said comorbidity. Hyperuricemia was defined as a serum urate level >7.0 mg/dL in men and >5.7 mg/dL in women. All statistical analyses were conducted using survey commands of Stata (Version 15.1, Stata Corporation, College Station, Texas) to adjust for clusters and strata of the complex sample design as well as incorporate sample weights. Population estimates (in millions) were calculated as per the NHANES analytic guidelines.
Results: Among gout patients, 69.4% (6.0 million) had hypertension, 55.9% (4.8 million) were obese, 26.5% (2.3 million) had type II diabetes mellitus (T2DM), 22.5% (1.9 million) had chronic kidney disease (CKD) stage ≥3, 19.9% (1.7 million) had nephrolithiasis†, 11.8% (1.0 million) had a myocardial infarction (MI), 11.1% (1.0 million) had heart failure (HF), and 8.7% (0.7 million) had suffered a stroke over 2007-2016. Among the US adults with both gout and hyperuricemia, 73.9% had hypertension, 60.8% were obese, 28.5% had CKD stage ≥3, 25.0% had T2DM, 18.2% had nephrolithiasis†, 11.9% had HF, 11.6% had a MI, and 9.3% had suffered a stroke (Table). These prevalences were substantially higher compared with individuals without gout or hyperuricemia. Hyperuricemia without gout was also associated with higher prevalences of comorbidities (all P-values < 0.005, Table). Among individuals with gout, the presence of hyperuricemia conferred additional risk for hypertension, CKD and obesity (all P-values<0.05, Table).
Conclusion: The findings from this recent, nationally-representative sample of US adults highlight that both gout patients and those with hyperuricemia continue to carry a substantial burden of cardiovascular-renal-metabolic comorbidities. These add to the overall disease burden of gout and hyperuricemia to society, and provide support for the consideration of these comorbidities in optimizing gout and hyperuricemia care in the US.
Table. Prevalence of Comorbidities According to Gout and Hyperuricemia* in NHANES 2007-2016
|
Comorbidities** |
Gout |
No Gout |
||
|
Hyperuricemia |
No Hyperuricemia |
Hyperuricemia |
No Hyperuricemia |
|
|
Hypertension |
73.9 (68.6, 78.6) |
65.4 (60.9, 69.6) |
47.6 (45.5, 49.7) |
26.3 (25.2, 27.4) |
|
Obesity (BMI ≥30 kg/m2) |
60.8 (55.6, 65.7) |
51.4 (45.0, 57.7) |
56.9 (54.8, 59.0) |
30.6 (29.4, 31.8) |
|
CKD Stage ≥3 (GFR<60) |
28.5 (24.2, 33.2) |
17.5 (14.4, 21.1) |
15.8 (14.5, 17.2) |
3.2 (3.0, 3.5) |
|
Type 2 diabetes mellitus |
25.0 (20.3, 30.4) |
25.7 (21.5, 30.5) |
13.0 (11.8, 14.2) |
7.8 (7.2, 8.3) |
|
Nephrolithiasis† |
18.2 (14.0, 23.4) |
22.0 (17.9, 26.8) |
10.2 (9.0, 11.4) |
8.5 (8.0, 9.1) |
|
Heart Failure |
11.9 (8.8, 15.8) |
9.8 (7.5, 12.7) |
5.0 (4.3, 5.8) |
1.4 (1.2, 1.6) |
|
Myocardial Infarction |
11.6 (8.7, 15.4) |
11.6 (8.9, 15.2) |
4.3 (3.7, 5.0) |
2.6 (2.3, 3.0) |
|
Stroke |
9.3 (6.2, 13.6) |
8.0 (6.1, 10.5) |
4.3 (3.8, 4.9) |
2.2 (2.0, 2.4) |
|
* Hyperuricemia defined as serum urate >7.0mg/dL for males and >5.7mg/dL for women ** Comorbidities were ordered by the descending prevalence of comorbidities among all individuals with gout and hyperuricemia † Data missing from NHANES 2015-16 CKD = chronic kidney disease; GFR = glomerular filtration rate (mL/min per 1.73m2) |
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To cite this abstract in AMA style:
Chen-Xu M, Yokose C, Pillinger M, Choi HK. Contemporary Comorbidity Burden of Gout and Hyperuricemia in the US during the Past Decade (National Health And Nutrition Examination Survey [NHANES] 2007-2016) [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/contemporary-comorbidity-burden-of-gout-and-hyperuricemia-in-the-us-during-the-past-decade-national-health-and-nutrition-examination-survey-nhanes-2007-2016/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/contemporary-comorbidity-burden-of-gout-and-hyperuricemia-in-the-us-during-the-past-decade-national-health-and-nutrition-examination-survey-nhanes-2007-2016/