The prevalence of metabolic syndrome may be nearly three times higher among individuals with gout, compared with unaffected individuals, judging from results of a recent data analysis.
Other researchers have suggested a link between gout and metabolic syndrome, but the degree of the overlap between the two conditions has been unclear, said Dr. Hyon K. Choi of the Arthritis Research Centre of Canada and his associates.
A total of 8,807 individuals aged 20 years or older participated in the third National Health and Nutrition Examination Survey (NHANES-III) from 1988 to 1994. Of those, 233 had gout, according to self-report (mean age of 58 years). All of the subjects were assessed for metabolic syndrome; the condition was deemed to be present if an individual had at least three of the following five metabolic abnormalities: abdominal obesity, hypertriglyceridemia, low HDL cholesterol, high blood pressure, and high fasting glucose.
Prevalence of metabolic syndrome was about 63% in the 233 individuals with gout and 25% in the 8,574 individuals without gout. The prevalence rates of each of the five the metabolic abnormalities associated with metabolic syndrome were considerably higher in adults with gout than they were in those without gout. For one, the prevalence of high blood pressure in individuals with gout (69%) was more than double the prevalence of those without gout. The association between metabolic abnormalities and gout was evident across subgroups of major associated gout risk factors including body mass index, hypertension, and diabetes, the investigators reported (Arthritis Rheum. 2007;57:109–15).
The interplay between hyperuricemia and high insulin levels caused by insulin resistance may explain the connection between metabolic syndrome and gout. The high insulin levels associated with insulin resistance are known to cause hyperuricemia, which enhances crystal deposition, thereby leading to symptomatic gout. Prevalence of hyperuricemia was 49% in individuals with gout and 18% in those without, according to the authors.
Prevalence of metabolic syndrome increased from 27% in participants with gout aged 20–39 years to 72% in participants aged 40–59. Prevalence of metabolic syndrome in individuals without gout increased from only 12% in adults aged 20–39 years to 31% in those aged 40–59 years, indicating that adults with gout are at greater risk of developing metabolic syndrome. The data also suggest that this risk is greater in older adults with gout than in younger adults with gout. Prevalence for metabolic syndrome in adults over age 60 years with gout (71%) was more substantial than in those without gout (49%).
Individuals with gout also may be at higher risk for developing atherosclerotic cardiovascular disease and type 2 diabetes, noted the researchers. The two diseases are known complications associated with metabolic syndrome. The study was funded by TAP Pharmaceutical Products Inc. and Savient Pharmaceuticals Inc. Dr. Choi reported receiving consulting fees from both companies.