Gout & Type 2 Diabetes

mother_and_daughterThe presence of gout was independently associated with later development of type 2 diabetes, a link that was particularly strong for women, a population-based study reported online in Annals of the Rheumatic Diseases.

The incidence rate for type 2 diabetes among individuals with gout was 9.6 (95% CI 9.4-9.8) per 1,000 person-years, compared with 6.7 (95% CI 6.6-6.8) per 1,000 among the general population, according to Hyon K. Choi, MD, and colleagues from Boston University.

Although gout’s cardinal feature is excruciatingly painful inflammatory arthritis, it is a metabolic condition associated with an elevated uric acid burden. Thus, gout is associated with obesity, hypertension, the metabolic syndrome, and an increased future risk of major cardiovascular events and premature mortality,” they wrote.

There are several possible explanations for the link between gout and diabetes, he noted. “One is that the two conditions share pathogenic factors, primarily associated with the metabolic syndrome. A second is that uric acid levels or other gout features such as inflammation may somehow contribute,” he said.

“Furthermore, the link between hyperuricemia and the risk of type 2 diabetes may originate at the renal level, as insulin resistance and higher insulin levels are known to reduce renal excretion of urate,” he and his colleagues wrote.

As to why the association was stronger for women, they suggested that there may be differences in the metabolism of uric acid between women and men, and the physiologic effects of high uric acid may be greater for women.