BACKGROUND: We hypothesized that women with early- and mid-adult life obesity, as well as high mid-adult life waist-to-hip ratios, and high weight gain during adulthood, experience a greater incidence of gout. METHODS: We examined the incidence of gout in the Atherosclerosis Risk in Communities Study, a population-based biracial cohort comprised of individuals aged 45-65 years at baseline (1987-1989). A total of 6263 women without prior history of gout were identified. We examined the association of body mass index (BMI) and obesity at cohort entry and at age 25 years, waist-to-hip ratio, and weight change with gout incidence (1996-1998). RESULTS: Over 9 years of follow-up, 106 women developed gout. The cumulative incidence of gout, by age 70 years, according to BMI category at baseline of <25, 25-29.9, 30-34.9, and ≥35 kg/m 2, was 1.9, 3.6, 7.9, and 11.8%, respectively (P <.001). Obese women (BMI <30) at baseline had an adjusted 2.4-fold greater risk of developing gout than nonobese women (95% confidence interval [CI], 1.53-3.68). This association was attenuated after further adjustment for urate levels. Further, early adult obesity in women was associated with a 2.8-fold increased risk of gout compared with nonobese women (95% CI, 1.33-6.09), which remained statistically significant after baseline urate adjustment. There was a graded association between each anthropometric measure, including weight gain, with incident gout (each P for trend <.001). The results were similar in black and white women. CONCLUSIONS: In a large cohort of black and white women, obesity in early- and mid-adulthood, and weight gain during this interval, were each independent risk factors for incident gout in women.
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Conflict of Interest: Alan Baer and Mara McAdams DeMarco received grant funding from Takeda Pharmaceuticals North America, Inc. in support of their effort on this project.
Funding: The Atherosclerosis Risk in Communities Study (ARIC) is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute (NHLBI) contracts N01-HC-55015 , N01-HC-55016 , N01-HC-55018 , N01-HC-55019 , N01-HC-55020 , N01-HC-55021 , and N01-HC-55022 . In addition, Dr. Maynard was supported by National Institutes of Health (NIH) 1KL2RR025006 . Ms. McAdams Demarco was supported by NIH NHLBI 5T32HL007024 . Drs. Janet Maynard, Allan Gelber and Alan Baer were supported by the Donald B. and Dorothy Stabler Foundation. Dr. Allan Gelber also was supported by the Ira T. Fine Discovery Fund. Dr. Anna Kottgen was supported by the Emmy Noether Program of the German Research Foundation. Alan Baer and Mara McAdams Demarco received grant funding from Takeda Pharmaceuticals North America, Inc. in support of their effort on this project.
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