title: Incident gout in women and association with obesity in the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: BACKGROUND
  We hypothesized that women with early- and mid-adult life obesity, as well as high mid-adult life waist-to-hip ratios, and high weight gain during adulthood, experience a greater incidence of gout.
  
  
  METHODS
  We examined the incidence of gout in the Atherosclerosis Risk in Communities Study, a population-based biracial cohort comprised of individuals aged 45-65 years at baseline (1987-1989). A total of 6263 women without prior history of gout were identified. We examined the association of body mass index (BMI) and obesity at cohort entry and at age 25 years, waist-to-hip ratio, and weight change with gout incidence (1996-1998).
  
  
  RESULTS
  Over 9 years of follow-up, 106 women developed gout. The cumulative incidence of gout, by age 70 years, according to BMI category at baseline of <25, 25-29.9, 30-34.9, and ≥35 kg/m(2), was 1.9, 3.6, 7.9, and 11.8%, respectively (P <.001). Obese women (BMI ≥30) at baseline had an adjusted 2.4-fold greater risk of developing gout than nonobese women (95% confidence interval [CI], 1.53-3.68). This association was attenuated after further adjustment for urate levels. Further, early adult obesity in women was associated with a 2.8-fold increased risk of gout compared with nonobese women (95% CI, 1.33-6.09), which remained statistically significant after baseline urate adjustment. There was a graded association between each anthropometric measure, including weight gain, with incident gout (each P for trend <.001). The results were similar in black and white women.
  
  
  CONCLUSIONS
  In a large cohort of black and white women, obesity in early- and mid-adulthood, and weight gain during this interval, were each independent risk factors for incident gout in women.
authors.affiliation: Division of Rheumatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Janet W
authors.initials: JW
authors.lastname: Maynard
authors.forename: Mara A
authors.initials: MA
authors.lastname: McAdams DeMarco
authors.forename: Alan N
authors.initials: AN
authors.lastname: Baer
authors.forename: Anna
authors.initials: A
authors.lastname: Köttgen
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
mesh_terms: D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D049629:Waist-Hip Ratio; D015430:Weight Gain