title: Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study.
abstract: BACKGROUND
  Limited prospective information exists on the relation between obesity and weight change and the risk of gout. Similarly, both hypertension and diuretic use have been considered risk factors for gout; however, their independent contributions have not been established prospectively.
  
  
  METHODS
  We prospectively examined over a 12-year period (1986-1998) the relation between adiposity, weight change, hypertension, and diuretic use and incident gout in 47,150 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout.
  
  
  RESULTS
  During 12 years we documented 730 confirmed incident cases of gout. Compared with men with a body mass index (BMI) of 21 to 22.9, the multivariate relative risks (RRs) of gout were 1.95 (95% confidence interval [CI], 1.44-2.65) for men with a BMI of 25 to 29.9, 2.33 (95% CI, 1.62-3.36) for men with a BMI of 30 to 34.9, and 2.97 (95% CI, 1.73-5.10) for men with a BMI of 35 or greater (P for trend <.001). Compared with men who had maintained their weight (+/-4 lb) since age 21 years, the multivariate RR of gout for men who had gained 30 lb or more since age 21 years was 1.99 (95% CI, 1.49-2.66). In contrast, the multivariate RR for men who had lost 10 lb or more since the study baseline was 0.61 (95% CI, 0.40-0.92). The multivariate RRs of gout were 2.31 (95% CI, 1.96-2.72) for the presence of hypertension and 1.77 (95% CI, 1.42-2.20) for diuretic use.
  
  
  CONCLUSIONS
  Higher adiposity and weight gain are strong risk factors for gout in men, while weight loss is protective. Hypertension and diuretic use are also important independent risk factors for gout.
authors.affiliation: Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, MA 02114, USA. hchoi@partners.org
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
authors.forename: Karen
authors.initials: K
authors.lastname: Atkinson
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Karlson
authors.forename: Gary
authors.initials: G
authors.lastname: Curhan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004232:Diuretics / Q000009:adverse effects*; D005500:Follow-Up Studies; D006073:Gout / Q000453:epidemiology / Q000209:etiology*; D006282:Health Personnel; D006801:Humans; D006973:Hypertension / Q000150:complications*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D004232:Diuretics