Hyperthyroid and hypothyroid status was strongly associated with gout and weakly associated with hyperuricaemia.

Lai-Chu See,Chang-Fu Kuo,Jia-Rou Liu,Yu-Shien Ko,Shue-Fen Luo,Kuang-Hui Yu,Meng-Jiun Chiou,I-Jun Chou,Guoying Wang

doi:10.1371/journal.pone.0114579

Lai-Chu See, Chang-Fu Kuo + Show 7 more

Open Access

https://doi.org/10.1371/journal.pone.0114579

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Abstract

ObjectivesThe aim of this study was to estimate the risk of hyperuricaemia and gout in people with hypothyroid or hyperthyroid status.MethodsThis study analyzed data from individuals who participated in health screening programs at Chang Gung Memorial Hospital in northern Taiwan (2000–2010). Participants were categorized as having euthyroid, hypothyroid, or hyperthyroid status according to their thyroid-stimulating hormone (TSH) levels. Multinomial logistic regression models were used to calculate the odds ratios (95% CI) for hyperuricaemia and gout in participants with thyroid dysfunction compared to euthyroid participants.ResultsA total of 87,813 (euthyroid, 83,502; hypothyroid, 1,460; hyperthyroid, 2,851) participants were included. The prevalence of hyperuricaemia was higher in hyperthyroid subjects (19.4%) than in euthyroid subjects (17.8%) but not in hypothyroid subjects (19.3%). The prevalence of gout was significantly higher in both hypothyroid (6.0%) and hyperthyroid (5.3%) subjects than in euthyroid subjects (4.3%). In men, hypothyroid or hyperthyroid status was not associated with hyperuricaemia. However, hypothyroid or hyperthyroid status was associated with ORs (95% CI) of 1.47 (1.10–1.97) and 1.37 (1.10–1.69), respectively, for gout. In women, hypothyroid status was not associated with hyperuricaemia or gout. However, hyperthyroid status was associated with ORs (95% CI) of 1.42 (1.24–1.62) for hyperuricaemia and 2.13 (1.58–2.87) for gout.ConclusionsBoth hyperthyroid and hypothyroid status were significantly associated with gout and weakly associated with hyperuricaemia. A thyroid function test for gout patients may by warranted.

Highlights

Gout and Hyperuricaemia in People with Thyroid Dysfunction. Both hyperthyroid and hypothyroid status were significantly associated with gout and weakly associated with hyperuricaemia
Gout is the most common inflammatory arthritis caused by hyperuricaemia and monosodium urate crystal deposition in joints and surrounding tissues [1]
This study used anonymised data is exempted from patient consents, which procedure was approved by the Institutional Review Board of the Chang Gung Memorial Hospital (CGMH)

Summary

Introduction

Gout is the most common inflammatory arthritis caused by hyperuricaemia and monosodium urate crystal deposition in joints and surrounding tissues [1]. Other risk factors include male gender [9], increased age [9, 10], obesity [11], high purine and alcohol intake [12], chronic renal impairment [13] and the use of diuretics and other drugs [14, 15]. Previous studies have reported high prevalence of hyperuricaemia in patients with both hypothyroidism [18] and hyperthyroidism [18, 19]. A possible explanation for these potential associations is the ability of thyroid hormone to influence serum urate levels through regulation of glomerular filtration rate [20]. Only several older case series reported an association between gout and hypothyroidism [21,22,23] and the association between hyperthyroidism and gout has not been reported

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