Effects of bariatric surgery on gout incidence in the Swedish Obese Subjects study: a non-randomised, prospective, controlled intervention trial

Maglio, Cristina; Peltonen, Markku; Neovius, Martin; Jacobson, Peter; Jacobsson, Lennart; Rudin, Anna; Carlsson, Lena

doi:10.1136/annrheumdis-2016-209958

Cited by 71 publications

(51 citation statements)

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“…The Swedish Obese Subjects (SOS) study is a longitudinal controlled study on the effect of bariatric surgery on mortality and on the incidence of obesity-related diseases [ 15 , 16 ]. We have recently shown that, in individuals with obesity, bariatric surgery associates with a lower risk of developing gout and psoriasis, two common inflammatory diseases [ 17 , 18 ]. The aim of this study was to determine whether bariatric surgery associated with a lower incidence of RA in SOS study participants.…”

Section: Introductionmentioning

confidence: 99%

Bariatric surgery and the incidence of rheumatoid arthritis – a Swedish Obese Subjects study

et al. 2019

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Objective The aim of this study was to determine the effect of bariatric surgery on the incidence of RA in participants of the Swedish Obese Subjects (SOS) study. Methods The SOS is a longitudinal study aiming to assess the effect of bariatric surgery on mortality and obesity-related diseases. This report includes 2002 subjects with obesity who underwent bariatric surgery and 2034 matched controls; none of them had RA at baseline. Cases of incident RA were identified through the Swedish National Patient Register by searching for International Classification of Diseases codes. Both intention-to-treat analyses and per-protocol analyses are reported. In the per-protocol analysis, participants from the control group who underwent bariatric surgery later on during follow-up were censored at the time of surgery. Results During follow-up, 92 study participants developed RA. The median follow-up was 21 years (range 0–29). Bariatric surgery was neither associated with the incidence of RA in the intention-to-treat analysis [hazard ratio (HR) 0.92 (95% CI 0.59, 1.46), P = 0.74], nor in the per-protocol analysis [HR 0.86 (95% CI 0.54, 1.38), P = 0.53]. Weight change at the 2 year follow-up, expressed as the change in BMI compared with baseline, did not associate with the development of RA. Higher serum CRP levels and smoking associated with the future development of RA independent of other factors. Conclusions We did not detect any association between bariatric surgery and the incidence of RA in subjects affected by obesity followed up for up to 29 years. ClinicalTrials.gov (http://clinicaltrials.gov): NCT01479452.

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Section: Introductionmentioning

confidence: 99%

Bariatric surgery and the incidence of rheumatoid arthritis – a Swedish Obese Subjects study

et al. 2019

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“…Our hypothetical scenarios are consistent with previous studies that examined the effect of weight change on gout. Studies on the effects of weight-loss interventions from either bariatric surgery or lifestyle modi cation are associated with reduced incidence of gout 28,31,32,33 . A systematic review 34 shows that a weight loss of >3.5 kg showed bene cial effects on gout attacks at mediumterm/long-term follow-up.…”

Section: Comparison Between Previous Studies and Our Resultsmentioning

confidence: 99%

Incident gout and weight change patterns: a retrospective cohort study of US adults

Bai

Zhou

Wang

et al. 2020

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OBJECTIVE To investigated the association between weight change patterns across adulthood and incident gout. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES), we categorized individuals into four weight-change groups based on their recalled weight during young adulthood and midlife. Hazard ratios (HR) and 95% CI relating weight change patterns to incident gout over 10-year follow-up were calculated. The hypothetical population attributable fraction (PAF) for the weight change patterns was calculated. RESULTS Among our sample of adults who were 40–74 years old at their midlife weight measure (n = 11079), 320 developed to gout. Compared with participants who remained stable non-obese during adulthood, the highest risks were found for gaining weight (HR 1.65; 1.19–2.29) participants. And stable obese pattern had a marginal significance of the elevated risk of incident gout conditions (HR 1.84; 0.98–2.78). No significant associations were found between losing weight change patterns and the risk of gout during the study period. If participants who gained weight had become non-obese during the 10-year follow-up, an estimated 3.2%(95% CI: 0-6.3) of observed gout cases could have been averted. Also, if the population had maintained a normal BMI, 32.9%(95% CI: 18.2–44.9) of cases could have been prevented during the ten years. CONCLUSIONS Gaining weight over adulthood was associated with increased risks of gout. These findings highlight that maintaining non-obese weight and weight loss across adulthood is essential for the prevention and treatment of gout in adult life.

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“…In einer prospektiven kontrollierten schwedischen Studie wurde gezeigt, dass die Inzidenz einer Hyperurikämie nach bariatrischer OP im Vergleich zu konventionell therapierten Patienten über ein Follow-up von 15 Jahren signifikant geringer war [33]. Dies ging mit einer signifikanten Abnahme des Gicht-Risikos einher (HR 0,6; 95 %-KI: 0,48-0,75).…”

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Stoffwechselkrankheit Gicht

Reuß‐Borst¹,

Tausche²

2018

Akt Rheumatol

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ZusammenfassungDie Gicht ist die häufigste entzündliche Gelenkerkrankung. Ihr liegt mit der Hyperurikämie als Ursache eine metabolische Störung zugrunde. Abgelagerte Harnsäurekristalle führen zu den typischen anfallsartigen Gelenkentzündungen. In den letzten Jahrzehnten ist die Gichtinzidenz zusammen mit anderen metabolischen Erkrankungen zunehmend. Der Rheumatologe ist besonders gefragt, wenn sich die Gicht klinisch nicht typisch manifestiert (oligo- und polyartikulär), also andere Differenzialdiagnosen infrage kommen, wenn bereits Komplikationen aufgetreten sind (fortgeschrittene Arthropathie, tophöse Gicht, zunehmende Nierenfunktionseinschränkung) oder wenn sich die Therapie aufgrund von Komorbiditäten schwierig gestaltet. Im Allgemeinen ist die Diagnostik der Gicht für den erfahrenen Rheumatologen keine Herausforderung, zumal er über Tools wie die Gelenksonografie und Gelenkpunktion mit mikroskopischer Beurteilung von Synovialflüssigkeit verfügt. Auch erscheint die Behandlung der Gicht als „treat-to-target“-Konzept in Analogie zu anderen entzündlich-rheumatischen Erkrankungen und aufgrund effektiver therapeutischer Optionen vergleichsweise übersichtlich. Immer wieder kommt jedoch die Frage nach eventuell modifizierbaren Faktoren bei der Entstehung der Hyperurikämie und Gicht auf. Die vorliegende Arbeit richtet den Fokus auf die Beeinflussung der zugrundeliegenden metabolischen Ursachen unter Berücksichtigung aktueller wissenschaftlicher Erkenntnisse. Ziel ist es, den Fokus von der rein symptomatischen Therapie der Entzündung im Gichtanfall hin auf die kausale Beeinflussung der metabolischen Harnsäure-Homöostase zu richten. Dazu gehört neben diätetischen Maßnahmen auch die Modifikation von Harnsäure-erhöhenden Faktoren wie Komedikationen.

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Effects of bariatric surgery on gout incidence in the Swedish Obese Subjects study: a non-randomised, prospective, controlled intervention trial

Cited by 71 publications

References 43 publications

Bariatric surgery and the incidence of rheumatoid arthritis – a Swedish Obese Subjects study

Bariatric surgery and the incidence of rheumatoid arthritis – a Swedish Obese Subjects study

Incident gout and weight change patterns: a retrospective cohort study of US adults

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