Background/Purpose:

Gout has long been recognised to cluster within families. However, formal evidence for familial aggregation is scant and discordant and the magnitude of any genetic component remains unclear. Therefore we undertook the present study to estimate the familial risk of gout in individuals with affected first-degree relatives compared to individuals with no affected first-degree relatives.  We also estimated the heritability and population attributable risk to assess the magnitude of genetic contribution to susceptibility to gout.

Methods:

Using data from the National Health Insurance Research Database in Taiwan, we conducted a nationwide cross-sectional study of data collected from 11,770,921 men and 11,697,080 women in 2004. The case definition of gout consisted of a physician diagnosis and the use of gout-specific treatment. We identified individuals with first-degree relatives affected by gout and compared the prevalence of disease between individuals with and without affected first-degree relatives. The marginal Cox proportional hazard model with an equal follow-up time for all subjects was used to estimate RR and the 95% confidence interval (CI). This model was used to account for shared environment and case clustering within families with robust variance, and to adjust for age, place of residence, income levels and occupation. The RR was estimated for different first-degree relative categories and for the number of first-degree relatives affected by gout. eritability (h²) was estimated using the multifactorial polygenic model. 

Results:

The prevalence of gout was higher in individuals with affected first-degree relatives (6.92%) than those without (4.83%). The overall familial relative risk (RR) was 1.92 (95% CI, 1.90–1.93). The RRs (95% CIs) for an individual with an affected twin, sibling, offspring and parent were 2.89 (2.65–3.16), 2.26 (2.21–2.32), 2.07 (2.05–2.09) and 1.77 (1.75–1.78), respectively. The RR (95% CI) increased with the number of affected first-degree relatives, from 1.86 (1.85–1.88), 3.02 (2.95–3.09) and 4.48 (4.07–4.92) for one, two or three or more affected relatives. The heritability of gout was 0.46 (95% CI, 0.44–0.47). The population attributable risk associated with familial aggregation in Taiwan was 5.77% (95% CI, 5.65%–5.82%). 

Conclusion:

This first ever population-based study confirms that gout aggregates within families. The heritability of gout is high in the general population in Taiwan and genetic predisposition contributes to a significant proportion of gout development.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/familial-aggregation-and-heritability-of-gout-in-taiwan-a-nationwide-population-study/