Background/Purpose: Among women, the prevalence of gouty arthritis (gout) and hyperuricemia (serum urate>6.0 mg/dL) increases steeply after the age 60. This increase has been attributed to menopause, and its attendant declines in circulating concentrations of reproductive hormones.  However it is not clear whether the ‘effect’ of menopause is merely a reflection of increasing age as these two factors are tightly correlated.

Methods: We performed multiple unmatched and age matched  case-control analyses using data on women aged 20-60 years from the NHANES1999-2010 cycles. For the latter, each case of gout, defined as self-reported physician diagnosis, 3 age-matched controls were chosen at random. Menopause was defined as absence of menstrual bleeding in the preceding 12 months, excluding those caused by pregnancy, medications, hormones, medical conditions or surgical procedures. Unmatched and matched multivariable analyses were performed by Survey weighted logistic regressions that adjusted for age, body mass index, ethnicity, hypertension and serum creatinine. Models were repeated with hyperuricemia as the outcome variable.

Results: A) Gout: In unmatched analyses,  the bivariate and multivariable  odds ratio for menopause were 3.0(1.4,6.5) and 1.3(0.6,2.7) respectively. In the age-matched analyses, bivariate odds ratio was 0.9 (0.4,1.8) and multivariate odds ratio was not significant. B) Hyperuricemia: In unmatched analyses the odds ratio for menopause in bivariate and multivariable models were 2.3 (2.0-2.8) and 1.25(1.01-1.54) respectively. In age-matched logistic regression models,  the bivariate and multivariable odds ratios were 1.3(1.1,1.4) and 0.98(0.86-1.11) respectively

Conclusion: After offsetting the effect of age by matching, menopausal status was not associated with increased prevalence of gout or hyperuricemia.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/menopause-and-the-prevalence-of-gout-and-hyperuricemia-an-age-matched-case-control-study/