2036 - Weight Loss and the Risk of Hyperuricemia Among Men with a High Cardiovascular Risk Profile

Wednesday, October 21, 2009: 11:45 AM
203 B (Pennsylvania Convention Center)
Yanyan Zhu1, Y. Zhang1, Eswar Krishnan2 and Hyon K. Choi3, 1BUSM, Boston, MA, 2Stanford University School of Medicine, Palo Alto, CA, 3Boston University School of Medicine, Boston, MA
Presentation Number: 2036

Purpose:   Hyperuricemia is the precursor of gout, which is the most common inflammatory arthritis for adult men.  Furthermore, serum uric acid levels are associated with several major conditions, including cardiovascular disorders, renal function decline, the metabolic syndrome, and type 2 diabetes.  Adiposity is a major determinant for hyperuricemia, but little is known about the quantitative impact of weight loss on the risk of hyperuricemia.  To estimate this impact, we performed a longitudinal analysis of 12,465 men with a high cardiovascular risk profile, who participated in the Multiple Risk Factor Intervention Trial (MRFIT).

Method:  We analyzed the relation between weight change and hyperuricemia using data prospectively collected at baseline and annually over a 6-year period (79,112 observations from 12,465 men).  Our primary definition of hyperuricemia was 6 mg/dL, a widely accepted therapeutic target.  We performed longitudinal analysis using logistic regression with generalized estimating equations to incorporate correlations of repeated observations in a given participant.  Our final multivariate model was adjusted for baseline covariates (age, education, weight) and time-varying covariates (alcohol intake, hypertension, serum creatinine level, diuretic use and fructose use).

Results: The mean age was 46 years and mean BMI was 28 kg/m2. The mean serum uric acid was 6.79 mg/dl and 73% were hyperuricemic at baseline.  Consistent with the intent of the risk factor intervention trial, weight loss was observed in 38% of visits (Table).  There was a graded relation between weight loss and reduction in the risk of hyperuricemia, and weight loss of 10 kg or more led to a 51% lower risk of hyperuricemia (Table).  Overall, weight change of 1kg led to a 5% change in the risk of hyperuricemia (p for trend <0.0001).

Conclusion:   This prospective data indicate that weight reduction could substantially help achieve a widely-accepted therapeutic uric acid target level (6mg/dL) among men with a high cardiovascular risk profile.  Weight loss of 10 kg or more could lead to a 51% lower risk of hyperuricemia.

Table. Odds Ratios of Hyperuricemia (³ 6mg/dL) According to Weight Change in the MRFIT Study

Weight Change (kg)

Number of Visits (%)

Univariate OR (95% CI)

Multivariate OR (95% CI)

Loss ³ 10

2844 (3.59)

0.43 (0.39, 0.49)

0.49 (0.43, 0.55)

Loss 5 to 9.9

8524 (10.77)

0.75 (0.70, 0.81)

0.78 (0.73, 0.84)

Loss 1 to 4.9

19089 (24.13)

0.90 (0.86, 0.94)

0.91 (0.86, 0.95)

No Change (-0.9 to 0.9)

25590 (32.35)

1 (Referent)

1 (Referent)

Gain 1 to 4.9

15988 (20.21)

1.16 (1.10, 1.22)

1.15 (1.09, 1.22)

Gain 5 to 9.9

5520 (6.98)

1.61 (1.46, 1.76)

1.57 (1.43, 1.72)

Gain ³ 10

1557 (1.97)

1.65 (1.38, 1.96)

1.55 (1.29, 1.86)

p for trend

<0.0001

<0.0001


Keywords: gout and uric acid

Disclosure: Y. Zhu, None; Y. Zhang, None; E. Krishnan, None; H. K. Choi, None.