Anemia and the onset of gout in a population-based cohort of adults: Atherosclerosis Risk in Communities study Full Text
Arthritis Research & Therapy, 08/21/2012
McAdams–DeMarco MA et al. – The authors identified anemia as a novel risk factor for gout. Anemia was associated with an approximately 2–fold increased risk of gout independent kidney function and serum urate. These findings suggest that anemia is a risk factor for gout on par with other chronic conditions such as obesity and diabetes. The biological mechanism linking anemia to gout remains unclear.Methods
- This population–based cohort recruited 15,792 individuals in 1987–1989 from 4 US communities and contained 9–years of follow–up.
- Anemia was defined as hemoglobin <13.5 g/dL for men and <12 g/dL for women.
- Using a Cox Proportional Hazards model, the authors estimated the hazard ratio (HR) and confidence intervals (CI) of incident gout by baseline anemia, adjusted for confounders (sex, race, estimated glomerular filtration rate, body mass index, and alcohol intake) and clinical factors (coronary heart disease, congestive heart failure, diabetes, hypertension, diuretic use and serum urate level).
- Among the 10,791 participants, 10% had anemia at baseline.
- There were 271 cases of incident gout.
- Patients with anemia had a 2–fold increased risk of developing gout over 9 years (HR=2.01, 95% CI: 1.46, 2.76).
- Anemia was associated with incident gout independent of known gout risk factors, confounders and clinical risk factors (HR=1.73, 95% CI: 1.24, 2.41).
- This association persisted after additionally adjusting for serum urate level (HR=1.83, 95% CI: 1.30, 2.57).