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The following is a summary of “Impaired pulmonary function increases the risk of gout: evidence from a large cohort study in the UK Biobank,” published in the December 2024 issue of Pulmonology by Kang et al. 

The link between pulmonary function and gout risk has remained unclear despite the growing recognition of pulmonary function as a key factor in metabolic diseases.  

Researchers conducted a retrospective study to explore the relationship between pulmonary function and gout risk, along with the underlying biological mechanisms.  

They included 4,20,002 participants with complete pulmonary function data from the UK Biobank. Logistic regression assessed gout prevalence across different pulmonary function statuses. Propensity score matching (PSM) was used to create balanced groups, while Cox regression examined the risk association between reduced lung function and gout. Mendelian randomization (MR) analysis tested causal relationships. Non-linear associations were explored using restricted cubic spline (RCS) analysis, and mediation analysis investigated the role of blood biomarkers.  

The results showed higher gout prevalence in individuals with a preserved ratio of impaired spirometry (PRISm) (6.31%) and chronic obstructive pulmonary disease (COPD) (6.26%) compared to those with normal pulmonary function (3.45%). After adjusting for covariates, both PRISm (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.17-1.31) and COPD (OR 1.14, 95% CI 1.07-1.22) were significantly linked to gout. Longitudinal analysis indicated that reduced pulmonary function raised gout risk (hazard ratio [HR] 1.32, 95% CI 1.24-1.40). The MR suggested a potential causal effect of lower pulmonary function on gout risk. Subgroup analysis found significant interactions between pulmonary function and factors such as body mass index (BMI), physical activity, and diabetes status, RCS analysis revealed a non-linear relationship between pulmonary function and gout, following an inverse S-shaped curve. Mediation analysis identified urate levels (49.1%), C-reactive protein (CRP) levels (6.62%), monocyte counts (1.33%), and neutrophil counts (4.85%) as key mediators in the association between pulmonary function and gout risk.  

Investigators concluded that impaired pulmonary function was significantly associated with an increased risk of gout, with potential mediation by urate levels, inflammatory markers, and immune cell counts. 

Source: pubmed.ncbi.nlm.nih.gov/39736738/