Incidence and risk factors for gout in white men.
OBJECTIVE
To identify potentially modifiable risk factors for the development of gout.


METHODS
Longitudinal cohort study (The Johns Hopkins Precursors Study).


METHODS
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.


METHODS
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 (greater than 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.
Roubenoff
R
R
Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
Klag
M J
MJ
Mead
L A
LA
Liang
K Y
KY
Seidler
A J
AJ
Hochberg
M C
MC
D000328:Adult; D015331:Cohort Studies; D005500:Follow-Up Studies; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People