Association between sex hormones and gout: An analysis of the UK Biobank cohort

Yaoyao Jiang; Sen Liu; Gang Liu; An Pan; Miaomiao Peng; Yunfei Liao

doi:10.1016/j.steroids.2024.109422

Association between sex hormones and gout: An analysis of the UK Biobank cohort

Steroids. 2024 Apr 8:109422. doi: 10.1016/j.steroids.2024.109422. Online ahead of print.

Authors

Yaoyao Jiang¹, Sen Liu², Gang Liu², An Pan², Miaomiao Peng³, Yunfei Liao⁴

Affiliations

¹ Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³ Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China. Electronic address: peng_miaomiao@outlook.com.
⁴ Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China. Electronic address: 2009xh0824@hust.edu.cn.

PMID: 38599307
DOI: 10.1016/j.steroids.2024.109422

Abstract

Objectives: To investigate the associations between sex hormones and gout.

Methods: A total of 448,836 individuals free of gout at baseline were included from the UK Biobank. Cox regression models were used to estimate hazard ratios (HRs) for gout. Besides, we investigated the causal relationship between bioavailable testosterone (BAT) and gout using mendelian randomization (MR).

Results: There were differential effects in different testosterone active states in gout. One-unit higher log-transformed total testosterone (TT) was associated with a 52 % [95 % CI, 0.39-0.58] lower risk of gout in males. In contrast, free testosterone (FT) and BAT were associated with a 74 % [95 % CI, 1.38-2.20] and a 78 % [95 % CI, 1.41-2.25] higher risk of gout in males respectively. For MR, the weighted median [OR, 1.70; 95 % CI, 1.14-2.56;] and inverse variance-weighted [OR, 1.25; 95 % CI, 0.96-1.62; P = 0.09] method revealed significant and approximately significant positive effect of genetic liability to BAT levels on the risk of gout respectively.

Conclusions: Sex hormones were potentially associated with gout. Notably, we were the first to explore different testosterone states on gout and found that FT and BAT may increase the risk of gout in males, which is opposite to TT. And the former are active states of androgens, may be more accurately reflect the association between androgens and gout.

Keywords: Bioavailable testosterone; Free testosterone; Gout; Mendelian randomization; Sex hormones.