Association Between Gout and Comorbidities is Independent of Serum Urate Level

Sarfaroj Khan 


January 04, 2021


  • Cardiovascular comorbidities and chronic kidney disease (CKD) associate with increasing serum urate (SU) in modest (e.g. 1 mg/dl) increments.

  • Diabetes mellitus (DM) correlates negatively with SU level.

  • The association between gout and cardiovascular comorbidities, DM and hypercholesterolaemia is independent of SU level.

Why this matters

  • Prospective cohort studies are warranted to evaluate whether modest increases in SU levels associate with incident comorbidities.

Study design

  • A case-control study using data from the UK Biobank.

  • Participants with baseline serum urate and without gout were included in the analysis of the association between comorbidities and serum urate (n=458,781).

  • Data for 10,265 gout cases and 458,781 control participants were included in the analysis of the association between gout and comorbidities.

  • Funding: None.

Key results

  • Comorbidities associated with increasing SU level (adjusted OR [aOR] for each 1 mg/dL SU increase):

    • hypercholesterolemia (aOR, 1.10; 95% CI, 1.09-1.11);

    • ischaemic heart disease (aOR, 1.11; 95% CI, 1.09-1.12);

    • hypertension (aOR, 1.29; 95% CI, 1.28-1.30);

    • cardiac failure (aOR, 1.66; 95% CI, 1.52-1.82); and

    • CKD stage 3b or higher (aOR, 3.14; 95% CI, 3.02-3.26).

  • DM correlated negatively with SU level (aOR, 0.89; 95% CI, 0.88-0.90).

  • After adjusting for covariates including SU, gout associated independently with:

    • ischaemic heart disease (aOR, 1.21; 95% CI, 1.13-1.29);

    • DM (aOR, 1.21; 95% CI, 1.13-1.30);

    • hypercholesterolaemia (aOR, 1.28; 95% CI, 1.22-1.35);

    • hypertension (aOR, 1.75; 95% CI, 1.67-1.83); and

    • cardiac failure (aOR, 4.15; 95% CI, 2.98-5.79).


  • Gout status was ascertained using self-report and prescription data.

  • Recall bias.

Sandoval-Plata G, Nakafero G, Chakravorty M, Morgan K, Abhishek A. Association between serum urate, gout and comorbidities: a case-control study using data from the UK Biobank. Rheumatology (Oxford). 2020 Dec 13 [Epub ahead of print]. doi: 10.1093/rheumatology/keaa773. PMID: 33313843 View abstract

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: