title: Gout in Older Adults: The Atherosclerosis Risk in Communities Study.
abstract: BACKGROUND
  It is unclear whether traditional and genetic risk factors in middle age predict the onset of gout in older age.
  
  
  METHODS
  We studied the incidence of gout in older adults using the Atherosclerosis Risk in Communities study, a prospective U.S. population-based cohort of middle-aged adults enrolled between 1987 and 1989 with ongoing follow-up. A genetic urate score was formed from common urate-associated single nucleotide polymorphisms for eight genes. The adjusted hazard ratio and 95% confidence interval of incident gout by traditional and genetic risk factors in middle age were estimated using a Cox proportional hazards model.
  
  
  RESULTS
  The cumulative incidence from middle age to age 65 was 8.6% in men and 2.5% in women; by age 75 the cumulative incidence was 11.8% and 5.0%. In middle age, increased adiposity, beer intake, protein intake, smoking status, hypertension, diuretic use, and kidney function (but not sex) were associated with an increased gout risk in older age. In addition, a 100 µmol/L increase in genetic urate score was associated with a 3.29-fold (95% confidence interval: 1.63-6.63) increased gout risk in older age.
  
  
  CONCLUSIONS
  These findings suggest that traditional and genetic risk factors in middle age may be useful for identifying those at risk of gout in older age.
authors.affiliation: Department of Epidemiology, JHU Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Bridget Teevan
authors.initials: BT
authors.lastname: Burke
authors.affiliation: Department of Epidemiology, JHU Bloomberg School of Public Health, Baltimore, Maryland. Division of Nephrology, University Medical Center Freiburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Köttgen
authors.affiliation: Department of Surgery.
authors.forename: Andrew
authors.initials: A
authors.lastname: Law
authors.affiliation: Division of Nephrology, and.
authors.forename: Morgan
authors.initials: M
authors.lastname: Grams
authors.affiliation: Division of Rheumatology, JHU School of Medicine, Baltimore, Maryland.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Baer
authors.affiliation: Department of Epidemiology, JHU Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Department of Epidemiology, JHU Bloomberg School of Public Health, Baltimore, Maryland. Department of Surgery, mara@jhu.edu.
authors.forename: Mara A
authors.initials: MA
authors.lastname: McAdams-DeMarco
mesh_terms: D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters / Q000235:genetics*; D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000235:genetics; D005260:Female; D051246:Glucose Transport Proteins, Facilitative / Q000235:genetics*; D006073:Gout / Q000453:epidemiology* / Q000235:genetics*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000032:analysis
chemical_list: C116614:ABCG2 protein, human; D000070997:ATP Binding Cassette Transporter, Subfamily G, Member 2; D018528:ATP-Binding Cassette Transporters; D051246:Glucose Transport Proteins, Facilitative; D009363:Neoplasm Proteins; C411811:SLC2A9 protein, human; D014527:Uric Acid
keywords: Gout; Urate genetics