This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (97)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Ronenn Roubenoff, MD, MHS; Michael J. Klag, MD, MPH; Lucy A. Mead, ScM; Kung-Yee Liang, PhD; Alexander J. Seidler, PhD; Marc C. Hochberg, MD, MPH

JAMA. 1991;266(21):3004-3007.

Abstract
Objective.
—To identify potentially modifiable risk factors for the development of gout.

Design.
—Longitudinal cohort study (The Johns Hopkins Precursors Study).

Participants.
—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.

Outcome Measure.
—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 (>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.

(JAMA. 1991;266:3004-3007)

Author Affiliations
From the Divisions of Molecular and Clinical Rheumatology (Drs Roubenoff and Hochberg) and Internal Medicine (Drs Klag and Hochberg and Ms Mead), Department of Medicine, School of Medicine, the Welch Center for Prevention, Epidemiology, and Clinical Research (Drs Klag, Seidler, and Hochberg), and the Departments of Epidemiology (Drs Roubenoff, Klag, and Hochberg) and Biostatistics (Dr Liang), The Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md. Dr Roubenoff is now with the US Department of Agriculture, Human Nutrition Research Center on Aging, Tufts University, Boston, Mass, and Dr Hochberg is now with the University of Maryland School of Medicine, Baltimore.

Footnotes
Reprint requests to University of Maryland Professional Building, 419 W Redwood St, Suite 620, Baltimore, MD 21201 (Dr Hochberg).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Frequency, Risk, and Cost of Gout-related Episodes Among the Elderly: Does Serum Uric Acid Level Matter?
WU et al.
The Journal of Rheumatology 2009;36:1032-1040.
ABSTRACT | FULL TEXT  

Vitamin C Intake and the Risk of Gout in Men: A Prospective Study
Choi et al.
Arch Intern Med 2009;169:502-507.
ABSTRACT | FULL TEXT  

Obesity and arthritis
Magliano
Menopause Int 2008;14:149-154.
ABSTRACT | FULL TEXT  

The Effect of Age and Gender on Pharmacokinetics, Pharmacodynamics, and Safety of Febuxostat, a Novel Nonpurine Selective Inhibitor of Xanthine Oxidase
Khosravan et al.
J Clin Pharmacol 2008;48:1014-1024.
ABSTRACT | FULL TEXT  

Serum Urate as a Predictor of Clinical and Radiographic Progression in Parkinson Disease
Schwarzschild et al.
Arch Neurol 2008;65:716-723.
ABSTRACT | FULL TEXT  

Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men
Williams
Am. J. Clin. Nutr. 2008;87:1480-1487.
ABSTRACT | FULL TEXT  

Haemoglobin A1c, fasting glucose, serum C-peptide and insulin resistance in relation to serum uric acid levels--the Third National Health and Nutrition Examination Survey
Choi and Ford
Rheumatology (Oxford) 2008;47:713-717.
ABSTRACT | FULL TEXT  

Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study
Choi and Curhan
BMJ 2008;336:309-312.
ABSTRACT | FULL TEXT  

Independent Impact of Gout on Mortality and Risk for Coronary Heart Disease
Choi and Curhan
Circulation 2007;116:894-900.
ABSTRACT | FULL TEXT  

Pharmacokinetic interactions of concomitant administration of febuxostat and NSAIDs.
Khosravan et al.
J Clin Pharmacol 2006;46:855-866.
ABSTRACT | FULL TEXT  

The Effect of Mild and Moderate Hepatic Impairment on Pharmacokinetics, Pharmacodynamics, and Safety of Febuxostat, a Novel Nonpurine Selective Inhibitor of Xanthine Oxidase
Khosravan et al.
J Clin Pharmacol 2006;46:88-102.
ABSTRACT | FULL TEXT  

Pathogenesis of Gout
Choi et al.
ANN INTERN MED 2005;143:499-516.
FULL TEXT  

Suboptimal physician adherence to quality indicators for the management of gout and asymptomatic hyperuricaemia: results from the UK General Practice Research Database (GPRD)
Mikuls et al.
Rheumatology (Oxford) 2005;44:1038-1042.
ABSTRACT | FULL TEXT  

Obesity, Weight Change, Hypertension, Diuretic Use, and Risk of Gout in Men: The Health Professionals Follow-up Study
Choi et al.
Arch Intern Med 2005;165:742-748.
ABSTRACT | FULL TEXT  

Gout epidemiology: results from the UK General Practice Research Database, 1990-1999
Mikuls et al.
Ann Rheum Dis 2005;64:267-272.
ABSTRACT | FULL TEXT  

Purine-Rich Foods and the Risk of Gout in Men
Dohan et al.
NEJM 2004;350:2520-2521.
FULL TEXT  

Purine-Rich Foods, Dairy and Protein Intake, and the Risk of Gout in Men
Choi et al.
NEJM 2004;350:1093-1103.
ABSTRACT | FULL TEXT  

A case-control study of the association of diet and obesity with gout in Taiwan
Lyu et al.
Am. J. Clin. Nutr. 2003;78:690-701.
ABSTRACT | FULL TEXT  

The management of hyperuricemia and gout in patients with heart failure
Spieker et al.
Eur J Heart Fail 2002;4:403-410.
FULL TEXT  

Joint Injury in Young Adults and Risk for Subsequent Knee and Hip Osteoarthritis
Gelber et al.
ANN INTERN MED 2000;133:321-328.
ABSTRACT | FULL TEXT  

Hyperlipidaemia in hyperuricaemia and gout
EMMERSON
Ann Rheum Dis 1998;57:509-510.
FULL TEXT  

Gout and Risk for Subsequent Coronary Heart Disease: The Meharry-Hopkins Study
Gelber et al.
Arch Intern Med 1997;157:1436-1440.
ABSTRACT  

The Management of Gout
Emmerson
NEJM 1996;334:445-451.
FULL TEXT  

RISK FACTORS FOR GOUT
JWatch General 1991;1991:4-4.
FULL TEXT