Second-Hand Smoke and Its Synergistic Effect with a Body-Mass Index of >24.9 kg/m2 Increase the Risk of Gout Arthritis in Indonesia

Abstract

To analyze the association between smoking status (active smoking and exposure to Second-Hand Smoking (SHS)) and the synergistic effect of smoking status and BMI with gout risk, a community-based case-control design was undertaken among 385 participants, including 304 healthy controls and 81 gout patients from seven community health services. Adjusted Odd Ratios (AORs) and 95% Confidence Interval (CIs) of gout for active smoking and SHS were 3.26 (95% CI = 1.07~9.90) and 4.67 (95% CI = 2.18~10.00) compared to non-smokers. Time-dependent manner of active smoking and SHS significantly increased gout risk with AORs and 95% CIs of 5.95 (1.41~25.03) and 10.12 (3.51~29.14). Dose-dependency of active smokers and SHS showed AORs and 95% CIs of 5.15 (1.28~20.63) and 4.37 (1.33~14.28). Smoking 20 cigarettes (one pack) per day for one year is equivalent to one pack-year. Active smoking >20 pack-year and SHS > 26.5 pack-year increased gout risk with AORs and 95% CIs of 7.18 (1.53~33.67) and 9.95 (3.64~27.22). Participants who smoked (active smoking and SHS) and with Body Mass Index (BMI) of > 24.9 kg/m2 synergistically increased gout risk, with an AOR of 9.65 and 95% CI of 3.25~28.65, compared to BMI ≤ 24.9 kg/m2 and non-smoker. Smoking status (active smoking and SHS) and the synergistic effect of smoking status and BMI increased gout risk in Indonesia.

Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial

“…Currently, intermittent drug use for pain relief contributes to renal impairment risk that is attributed to under-excretion of urate and is a cause of death in gout patients (Kurniasari et al, 2021; Padang et al, 2006). This indicates that further research is required on gout pain management such as non-pharmacological or adjunct interventions (Abhishek & Doherty, 2018).…”

“…In a global ethnic group comparison, Malayo-Polynesian males had higher rates of gout and hyperuricemia than Caucasian men (Darmawan, 1992; Dyah Kurniasari et al, 2021). Another study also reported that gout is a common arthritic illness in Malayo-Polynesian people (Kurniasari et al, 2021; Padang et al, 2006), and Indonesians are included in the Malayo-Polynesian ethnic group (Klamer, 2019). These data indicate that gout disease is a significant public health problem in Indonesia after considering genetic factors and their interplay with environmental factors (Darmawan, 1992).…”

“…Data show that more than 50% of them had observed tophi for 7–9 years before presenting for treatment. This is due to a lack of information among people with gout and primary healthcare professionals, and a lack of availability of urate-lowering drugs in community health centers in Indonesia (Kurniasari et al, 2021; Padang et al, 2006). These facts indicate marked clinical and economic impacts of gout and the need for further research on successful gout management.…”

“…Although hospitalization rates for rheumatoid arthritis (RA) have declined, those for gout are growing (Fields, 2019). Among 11 Asian countries, Indonesia had the highest number of gout cases (Kurniasari et al, 2021). Likewise, a survey study among 4683 adults conducted in a rural area of Java Island, Indonesia, reported prevalences of gout and hyperuricemia in men of 1.7% and 24.3%, respectively.…”

“…is a common arthritic illness in Malayo-Polynesian people (Kurniasari et al, 2021;Padang et al, 2006), and Indonesians are included in the Malayo-Polynesian ethnic group (Klamer, 2019). These data indicate that gout disease is a significant public health problem in Indonesia after considering genetic factors and their interplay with environmental factors (Darmawan, 1992).…”