Association between female reproductive factors and gout: a nationwide population-based cohort study of 1 million postmenopausal women

Abstract

Background Previous studies have shown that the incidence and risk factors of gout differs according to sex. However, little research has been done on the association between reproductive factors and gout. We conducted an analysis of a large nationwide population-based cohort of postmenopausal women to determine whether there is an association between reproductive factors and the incidence of gout. Methods A total of 1,076,378 postmenopausal women aged 40–69 years who participated in national health screenings in 2009 were included in the study. The outcome was the occurrence of incident gout, which was defined using the ICD-10 code of gout (M10) in the claim database. Cox proportional hazard models were used for the analyses and stratified analyses according to body mass index (BMI) and the presence/absence of chronic kidney disease (CKD) were performed. Results The mean follow-up duration was 8.1 years, and incident cases of gout were 64,052 (incidence rate 7.31 per 1000 person-years). Later menarche, earlier menopause, and a shorter reproductive span were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC) and hormone replacement therapy (HRT) were associated with an increased risk of gout. The association between reproductive factors and gout was not statistical significant in the high BMI group. The effects of OC and HRT usage on gout were not significant in the CKD group. Conclusion Shorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increased risk of gout.

Assessment of the correlation between KAP scores regarding sugar-sweetened beverage consumption and hyperuricemia amongst Chinese young adults

“…Indeed, females are generally more concerned about body appearance [ 26 – 28 ], but older age was independently associated with higher attitude scores, as supported by an Australian study [ 26 ]. In addition, before menopause, women are protected by estrogens against the development of hyperuricemia and other metabolic disorders [ 29 – 31 ], possibly making younger women adopt a more casual attitude toward hyperuricemia. As individuals age, they can become more concerned with their health.…”

Association between gout and subsequent breast cancer: a retrospective cohort study including 67,598 primary care patients in Germany

“…Based on the fact that the median age at menopause among women from industrialized countries ranges between 50 and 52 years [40], one can assume that the menopause status may explains the exclusive significant association of gout and BC in women aged < 50. Indeed, it is known that postmenopausal women experience a higher occurrence of gout, while estrogen's uricosuric effect shields premenopausal women [41]. Given the positive association between hyperuricemia and higher cancer incidence (incl.…”

Association between weekend catch-up sleep and hyperuricemia with insufficient sleep in postmenopausal Korean women: a nationwide cross-sectional study

“…Studies have shown that the morbidity of CVDs is lower in premenopausal women than in men but increases in postmenopausal women, as much as in men, because of the loss of the hormonal protective effects of endothelial dysfunction, which hinders atherosclerosis and CVD 36 . In addition, because estradiol lowers serum uric acid levels by renal clearance, secretion, and reabsorption, postmenopausal women with low ovarian hormone levels have high uric acid levels 37 . A study reported that estradiol changes according to sleep patterns.…”

“… 36 In addition, because estradiol lowers serum uric acid levels by renal clearance, secretion, and reabsorption, postmenopausal women with low ovarian hormone levels have high uric acid levels. 37 A study reported that estradiol changes according to sleep patterns. Michels et al 38 found a decrease in average estradiol in women with sleep less than 7 hours per day.…”