Impaired Pulmonary Function Linked to Increased Gout Risk: Study

Researchers have found that reduced pulmonary function strongly increases the risk of developing gout. Pulmonary function is increasingly recognized as a vital component in metabolic diseases, but its connection to gout has remained unclear until now. A recent study was conducted by Zijan Kang and colleagues which was published in the journal BMC Medicine.

A total of 420,002 participants with pulmonary function testing results completely available in the study were analyzed. The propensity score matching (PSM) method was used to generate balanced comparison groups, and Cox regression was used to estimate the risk of gout in individuals with impaired pulmonary function. Mendelian randomization (MR) was applied to assess causal associations, and restricted cubic spline (RCS) analysis was used to examine non-linear relationships between pulmonary function and gout incidence. Biomarkers influencing the observed associations were identified through mediation analysis.

Key Findings

Prevalence of Gout:

  • Among individuals with PRISm, 6.31% had gout, compared to 6.26% in those with COPD and 3.45% in individuals with normal pulmonary function.

Risk of Gout:

  • Adjusted analysis revealed that PRISm increased gout odds by 24% (OR = 1.24, 95% CI 1.17–1.31), while COPD raised odds by 14% (OR = 1.14, 95% CI 1.07–1.22).

  • Longitudinal analysis confirmed a 32% increased risk of developing gout in individuals with impaired pulmonary function (HR = 1.32, 95% CI 1.24–1.40).

Biological Mechanisms:

  • The mediation analysis demonstrated that urate levels mediated 49.1% of the association between impaired pulmonary function and gout.

  • Other mediators included CRP levels (6.62%), monocyte counts (1.33%), and neutrophil counts (4.85%).

Non-linear Association:

  • RCS analysis showed an inverse S-shaped curve between pulmonary function and incidence of gout, which further indicates a complex non-linear association.

Subgroup Insights:

  • Significant interactions were found between impaired pulmonary function and factors such as BMI, physical activity, and diabetes status, which highlight their role in modulating gout risk.

Impaired pulmonary function is significantly related to an increased risk of gout. This relation, partially mediated by biomarkers such as levels of urate and inflammatory markers, underscores the interconnection of pulmonary and metabolic health. A proactive approach toward the management of pulmonary and metabolic conditions may serve as a way to reduce prevalence of gout and improve the overall health outcomes.

Reference:

Kang, Z., Zhang, J., Zhu, C. et al. Impaired pulmonary function increases the risk of gout: evidence from a large cohort study in the UK Biobank. BMC Med 22, 606 (2024). https://doi.org/10.1186/s12916-024-03836-8

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