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OSA and gout

Obstructive sleep apnoea associated with higher risk of gout

An elevated risk of developing gout was observed throughout follow-up for OSA patients, but it was highest one to two years after diagnosis of OSA

People with obstructive sleep apnoea (OSA) have a higher risk of developing gout, even beyond the first years after being diagnosed with the sleep disorder, according to researchers from Keele University, UK. OSA is associated with a range of serious comorbidities, and it has previously been shown that people with OSA have a higher risk of developing gout in the first year after diagnosis.

To investigate whether they may also be more likely to develop gout over a longer term, a team led by Drs Edward Roddy and Milica Blagojevic-Bucknall of Keele University in the UK, examined information on 15,879 patients with OSA and 63,296 without, with a median follow-up of 5.8 years.

The paper, ‘The risk of gout among patients with sleep apnea: a matched cohort study’, published in the journal Arthritis & Rheumatology, reported that 4.9% of OSA and 2.6% of non-OSA patients developed gout. Incidence rates per 1000 person-years were 7.83 and 4.03 among those with and without OSA, respectively, for a 42% increased risk among OSA patients (a person-year is the number of years of follow-up multiplied by the number of people in the analysis.)

An elevated risk of developing gout was observed throughout follow-up for OSA patients, but it was highest one to two years after diagnosis of OSA. This finding was seen in patients with normal body mass index as well as those who were overweight or obese; however, the risk was greater in those with normal weight.

"People with sleep apnoea are at an increased risk of gout in both the short and long term. Since this risk was highest in people with normal body mass index, doctors and other health professionals should consider the possibility of gout in patents with sleep apnoea regardless of body mass index," said Roddy.

It's thought that intermittent oxygen deficiency due to OSA leads to over- production of uric acid, which causes gout.

"Sleep apnea is commonly treated with continuous positive airways pressure or CPAP therapy,” said Blagojevic-Bucknall. “Since CPAP treatment corrects low oxygen levels it might also be expected to reduce uric acid levels, which could possibly reduce the risk of developing gout or treat existing gout; however, further research is needed to investigate the effect of treatment with CPAP in people with gout.”

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