WebMD Medical News
Brunilda Nazario, MD
Nov. 11, 2011 (Chicago) -- People with gout should make sure their uric acid levels are under control -- even if they're not experiencing symptoms of the painful arthritic disorder.
"Many people are walking around with uncontrolled uric acid levels and we used to not worry about it -- if they're not having symptoms, who cares?" says Eric Matteson, MD, MPH, head of rheumatology at Mayo Clinic in Rochester, Minn.
But new studies show that high uric acid levels in the blood are associated with a nearly 20% increased risk of developing diabetes and a more than 40% increased risk of developing kidney disease.
Uric acid is a chemical substance that can build up in the blood to a higher than normal level and lead to gout.
For the new studies, researchers reviewed the records of about 2,000 men with gout in a Veterans Administration database. None had diabetes or kidney disease at the start of the study.
Eswar Krishnan, MD, assistant professor of rheumatology at Stanford University, presented the findings here at the American College of Rheumatology's annual meeting. Krishnan consults for Takeda Pharmaceuticals International, which makes a gout medication and funded the study.
Over a three-year period, 9% of men with gout who had uncontrolled uric acid levels developed diabetes, compared with 6% of those whose uric levels were under control.
After taking into account other risk factors for diabetes, this corresponded to a 19% higher risk of diabetes in those with uncontrolled uric acid levels.
A blood uric acid level greater than 7 is considered uncontrolled.
The risk for an individual person might not be much. But the National Institutes of Health estimates that 6 million U.S. adults have had gout at some point in their lives, many with uncontrolled uric acid levels. That translates to tens of thousands of people at risk of diabetes and kidney disease, Matteson says.
A second study, conducted by the same researchers using the same database, showed that over a three-year period men with gout who had uncontrolled uric acid levels had a 40% greater risk of kidney disease compared to men with controlled uric acid levels.
The studies do not prove that uncontrolled uric acid levels cause the health problems but show an association of elevated levels to these health problems.
"Gout is a vastly undertreated disease," Matteson says. "Now we're finding that elevated uric acid, by itself, even if you have no gout, is associated with higher rates of heart attack, metabolic syndrome, diabetes, even death due to cardiovascular disease."
Still, it would be advisable to get uric acid levels under control, through diet or medication, he says.
Most importantly, maintain a healthy weight, Matteson says. Obesity is a major risk factor for all these conditions.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES:American College of Rheumatology's 75th Annual Scientific Meeting, Chicago, Nov. 4-9, 2011.Eric Matteson, MD, MPH, head of rheumatology, Mayo Clinic, Rochester, Minn.Eswar Krishnan, MD, assistant professor of rheumatology, Stanford University, Palo Alto, Calif.
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