Publications
This study explored the link between a pro-inflammatory dietary pattern and the risk of gout using data from three large cohorts. The results showed that individuals consuming diets with greater inflammatory potential had a significantly higher risk of developing gout. In contrast, those consuming diets with lower inflammatory potential had a much lower risk of gout, even when compared with key guideline-based healthy diets. Interestingly, these associations were stronger among women than men. These findings suggest that inflammation may play a key role in how diet affects gout risk, particularly among women.
Acute gout flares and kidney stones are among the most painful events humans can experience. This study compared the recurrence of kidney stones in patients with type 2 diabetes prescribed either SGLT-2 inhibitors or other diabetes medications like GLP-1 receptor agonists and DPP-4 inhibitors. We found that SGLT-2 inhibitors were associated with a lower rate of kidney stone recurrence and fewer hospital visits for kidney stones compared with other treatments, especially among patients with existing gout, as well as lower rate of recurrent gout flares. Overall, this study suggests that SGLT-2 inhibitors may provide dual added benefits (beyond glucose-lowering) for people with gout and kidney stone.
This study explored the relationship between blood metabolites and the risk of gout hospitalization, focusing on a large group of UK Biobank participants. We found that several metabolites, including glycine and glutamine, were associated with lower gout risk. These associations remained significant even after adjusting for serum urate levels. The findings were supported by Mendelian randomization, suggesting that these metabolites might have a causal role in gout risk. Overall, this research could help develop new biomarkers for predicting gout risk and guide future treatments, such as supplements with glycine or glutamine.
This study compared the risk of developing gout and the rate of recurrent gout flares in patients with type 2 diabetes (T2D) who were prescribed either sodium-glucose cotransporter type 2 inhibitors (SGLT2i) or sulfonylureas, a common alternative, in addition to metformin. The results showed that patients starting on SGLT2i had a significantly lower incidence of gout and fewer recurrent gout flares compared to those using sulfonylureas. SGLT2i also showed benefits in reducing major cardiovascular events and hospitalizations for heart failure, while having no impact on osteoarthritis. These findings suggest that SGLT2i may be a better choice for T2D patients at risk for gout, offering both gout and cardiovascular benefits.
This study investigated the relationship between adherence to various plant-based diets and the risk of developing gout using data from two large US cohorts. It found that a healthy plant-based diet (emphasizing whole grains, coffee, and tea) was associated with a lower risk of gout, while an unhealthy plant-based diet (high in refined grains, sugary beverages, and fruit juice) was associated with an increased risk, particularly in women. Overall, the findings support dietary recommendations to prioritize healthy plant foods and limit unhealthy plant-based options to reduce gout risk.
This study examined the impact of gout on premature mortality and trends over time. It found that survival improved in the general population over the past three decades, but the mortality gap persisted for gout. In both the US and UK, patients with gout had higher all-cause and cardiovascular mortality, even after adjusting for factors like serum urate and atherosclerotic cardiovascular disease risks. These associations were particularly strong in women and Black individuals. The study highlights that gout-related inflammation may contribute to these increased mortality rates, suggesting the need for better care, especially for certain patient groups.
This study examined whether baseline serum urate levels could predict the risk of future gout flares and hospitalizations in patients with a history of gout. The results showed that higher serum urate levels were strongly associated with more frequent gout flares and hospitalizations. For example, 95% of all gout flares occurred in those with baseline serum urate >6mg/dL, the target recommended by US and European rheumatology guidelines; 98% of flares occurred in those with urate >5mg/dL, as did all gout hospitalisations. These findings suggest that treating to a target serum urate level could help prevent the majority of recurrent gout flares.
This study compared the effects of SGLT2 inhibitors (SGLT2is) versus DPP-4 inhibitors (DPP-4is) on recurrent gout flares and cardiovascular events in patients with gout and type 2 diabetes. The results showed that SGLT2is were associated with significantly fewer gout flares and hospital visits compared to DPP-4is. And while conventional urate-lowering therapies can initially increase flare rates, this did not happen with SGLT2i initiation. SGLT2i use was also associated with reduced risk of myocardial infarction. These findings suggest that SGLT2is could be a beneficial treatment for gout patients, offering both gout flare prevention and cardiovascular benefits.
This study explored the relationship between blood metabolites and the risk of incident and recurrent gout among UK Biobank participants. We found that one metabolite in particular, glycoprotein acetyls, a biomarker of long-term inflammation, was strongly associated with increased risk of incident gout and higher rates of recurrent flares. These associations remained significant even after adjusting for serum urate levels, and were supported by Mendelian randomization, suggesting it might have a causal role in gout risk. Overall, this research could help develop new biomarkers for predicting gout risk and guide future treatments.
This study explored how genetic predisposition and diet interact to influence the risk of developing gout in four cohorts of women from the USA and UK. It found that women with a higher genetic risk scores for gout had a greater benefit from following a healthy diet, specifically the DASH diet, which was linked to a lower risk of incident gout. Overall, nearly half of the increased risk for gout in women was due to the combined effects of genetics and diet, emphasizing the importance of diet in managing genetic risk for gout.
This study examined racial and ethnic differences in emergency department (ED) visits and hospitalizations for gout in the U.S. using national datasets from 2019. It found that Black patients had significantly higher rates of both ED visits and hospitalizations for gout compared to White patients, with the most pronounced disparity observed among Black women. Asian and Hispanic patients also had higher rates than White patients, but the differences were smaller. These findings highlight significant racial and ethnic inequities in gout care, emphasizing the need for targeted improvements in healthcare to address these disparities.
This study investigated the prevalence of gout and serum urate concentrations among different racial and ethnic groups in the U.S., focusing on Asian individuals, using data from the National Health and Nutrition Examination Survey (NHANES) and the UK Biobank. It found that between 2011 and 2018, the prevalence of gout among Asian Americans doubled, surpassing that of other racial and ethnic groups, with a significant disparity in older adults. Despite adjusting for socioclinical factors, the gap between Asian and White individuals remained. These findings highlight a growing disparity in gout prevalence among Asian populations, which cannot be fully explained by social or clinical factors.
This study explored racial and sex differences in gout prevalence in the U.S. using national survey data from 2007 to 2016. It found that Black adults, especially Black women, had a higher prevalence of gout compared to White adults. However, after adjusting for factors like poverty, diet, body mass index, and kidney disease, the racial differences in gout prevalence disappeared. The study suggests that diet and social determinants of health play key roles in these disparities, highlighting the need for culturally tailored interventions to reduce gout-related inequities.
This study explored the combined association of excess adiposity and genetic predisposition for the risk of developing gout in both men and women. It found that the joint association of increased body mass index (BMI) and increased genetic risk score for risk of incident gout was greater than the sum of its parts (i.e., greater than the sum of each individual factor). This interaction was stronger among women than men. These findings underscore the importance of addressing excess adiposity for lowering the risk of gout in women, especially those who are more genetically predisposed.
This study explored the associations between adherence to healthy eating patterns, as recommended by the 2020-2025 Dietary Guidelines for Americans, and the risk of developing gout in women. Over 34 years of follow-up in the Nurses’ Health Study, women who adhered more closely to healthy diets, such as DASH, Mediterranean, AHEI, and Prudent diets, had significantly lower risks of developing gout, while those with a Western (unhealthy) diet had a higher risk. The study also found that combining a healthy diet with a normal body mass index or no diuretic use resulted in even greater risk reductions. These findings suggest that dietary patterns play a crucial role in preventing female gout and emphasize the importance of personalized, culturally adaptable dietary interventions.
This expert review explores the relationship between gout, hyperuricemia, and associated cardiometabolic-renal (CMR) conditions like hypertension, stroke, obesity, and chronic kidney disease. While studies show an independent link between elevated serum urate levels and CMR risk, Mendelian randomization suggests urate is not a causal factor. Advanced imaging has raised the possibility that urate crystals in coronary plaques may contribute to cardiovascular risk. Until further evidence is available, therapies like sodium-glucose cotransporter 2 (SGLT2) inhibitors and lifestyle changes offer significant benefits for both urate control and CMR outcomes in gout management.