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Article
December 4, 1991

Incidence and Risk Factors for Gout in White Men

Author Affiliations

From the Divisions of Molecular and Clinical Rheumatology (Drs Roubenoff and Hochberg) and Internal Medicine (Drs Klag and Hochberg and Ms Mead), Department of Medicine, School of Medicine, the Welch Center for Prevention, Epidemiology, and Clinical Research (Drs Klag, Seidler, and Hochberg), and the Departments of Epidemiology (Drs Roubenoff, Klag, and Hochberg) and Biostatistics (Dr Liang), The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md. Dr Roubenoff is now with the US Department of Agriculture, Human Nutrition Research Center on Aging, Tufts University, Boston, Mass, and Dr Hochberg is now with the University of Maryland School of Medicine, Baltimore.

From the Divisions of Molecular and Clinical Rheumatology (Drs Roubenoff and Hochberg) and Internal Medicine (Drs Klag and Hochberg and Ms Mead), Department of Medicine, School of Medicine, the Welch Center for Prevention, Epidemiology, and Clinical Research (Drs Klag, Seidler, and Hochberg), and the Departments of Epidemiology (Drs Roubenoff, Klag, and Hochberg) and Biostatistics (Dr Liang), The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md. Dr Roubenoff is now with the US Department of Agriculture, Human Nutrition Research Center on Aging, Tufts University, Boston, Mass, and Dr Hochberg is now with the University of Maryland School of Medicine, Baltimore.

JAMA. 1991;266(21):3004-3007. doi:10.1001/jama.1991.03470210072035
Abstract

Objective.  —To identify potentially modifiable risk factors for the development of gout.

Design.  —Longitudinal cohort study (The Johns Hopkins Precursors Study).

Participants.  —Of 1337 eligible medical students, 1271 (95%) received a standardized medical examination and questionnaire during medical school. The participants were predominantly male (91%), white (97%), and young (median age, 22 years) at cohort entry.

Outcome Measure.  —The development of gout.

Results.  —Sixty cases of gout (47 primary and 13 secondary) were identified among 1216 men; none occurred among 121 women (P =.01). The cumulative incidence of all gout was 8.6% among men (95% confidence interval, 5.9% to 11.3%). Body mass index at age 35 years (P =.01), excessive weight gain (>1.88 kg/m2) between cohort entry and age 35 years (P =.007), and development of hypertension (P =.004) were significant risk factors for all gout in univariate analysis. Multivariate Cox proportional hazards models confirmed the association of body mass index at age 35 years (relative risk [RR] = 1.12; P =.02), excessive weight gain (RR = 2.07; P =.02), and hypertension (RR = 3.26; P =.002) as risk factors for all gout. Hypertension, however, was not a significant risk factor for primary gout.

Conclusions.  —Obesity, excessive weight gain in young adulthood, and hypertension are risk factors for the development of gout. Prevention of obesity and hypertension may decrease the incidence of and morbidity from gout; studies of weight reduction in the primary and secondary prevention of gout are indicated.(JAMA. 1991;266:3004-3007)

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