Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies

Eur J Nutr. 2014 Dec;53(8):1591-601. doi: 10.1007/s00394-014-0766-0. Epub 2014 Sep 11.


Purpose: Greater body fatness has been associated with increased risk of gout in several studies; however, the strength of the association has differed between studies, and it is not clear whether the association differs by gender. We conducted a systematic review and meta-analysis of prospective studies to clarify the association between adiposity and risk of gout.

Methods: PubMed and Embase were searched up to August 30, 2013. Summary relative risks (RRs) were calculated using a random effects model.

Results: Ten prospective studies of body mass index (BMI) and gout risk with 27,944 cases and 215,739 participants were included (median follow-up 10.5 years). The summary RR for a 5 unit increment was 1.55 [95% confidence interval (95% CI) 1.44-1.66, I(2) = 67%] for all studies combined. The heterogeneity was explained by one study, which appeared to be an outlier. The summary RR per 5 BMI units was 1.62 (95% CI 1.33-1.98, I(2) = 79%) for men and 1.49 (95% CI 1.32-1.68, I(2) = 30%) for women, p(heterogeneity) = 0.72. The relative risks were 1.78, 2.67, 3.62, and 4.64 for persons with BMI 25, 30, 35, and 40 compared with persons with a BMI of 20. BMI in young adulthood, waist-to-hip ratio, and weight gain from age 21-25 to midlife were also associated with increased risk, but few studies were included in these analyses.

Conclusions: Greater body mass index increases risk of gout. Further studies are needed on adiposity throughout the life course, waist-to-hip ratio, and weight changes in relation to gout as there were few studies that had published on these exposures.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adiposity
  • Body Mass Index*
  • Databases, Factual
  • Female
  • Gout / complications
  • Gout / epidemiology*
  • Humans
  • Male
  • Obesity / complications
  • Obesity / epidemiology*
  • Prevalence
  • Risk Factors
  • Sensitivity and Specificity
  • Waist-Hip Ratio
  • Weight Gain