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Sleep apnea is associated with hyperuricemia owing
to hypoxia-induced nucleotide turnover and may
increase the risk of developing gout and
experiencing flare-ups, according to a new study.
The pain and swelling of a joint, a big toe, that
marks gout is caused by the deposition of uric acid
crystals in joints and tissues and sleep apnea
causes periods of oxygen deprivation during the
night when people stop breathing, which triggers
overproduction of uric acid in the bloodstream.
Gout in X-ray of left foot - "Gichtfuss im
Roentgenbild 002" di Hellerhoff - Opera propria
Using data from The Health Improvement Network in
the United Kingdom, lead author Yuqing Zhang of
Boston University Clinical Epidemiology Research and
Training Unit identified 9865 patients with
newly-diagnosed sleep apnea, 43,598 comparators, 270
incident cases of gout over one year of follow-up,
76 in the sleep apnea group and 194 in the larger
comparison group. Gout was diagnosed at an average
age of 60. Gout was almost twice as common in the
sleep apnea group as in the comparison group.
For each sleep apnea patient, up to five non-sleep
apnea individuals were matched on sex, age, birth
year, body mass index, and year of sleep apnea
diagnosis.
Scientists estimated the incidence rates of gout and
examined the relation of sleep apnea to the risk of
incident gout using a Cox proportional hazards
model, adjusting for potential confounders. In
addition, they assessed the rate difference in gout
due to sleep apnea using an additive hazard model.
It takes years for uric acid crystals to accumulate
in the joints and lead to an eventual gout flare, so
sleep apnea may not “cause” the gout, but may create
a more ideal environment for a flare up.
This general population-based study indicates that
sleep apnea is independently associated with an
increased risk of incident gout. Future research
should examine the potential benefits of correcting
sleep apnea-induced hypoxia on the risk of
hyperuricemia and gout flares.
For more information
Arthritis & Rheumatology
Sleep Apnea and the Risk of Incident Gout: A
Population-Based Body Mass Index-Matched Cohort
Study
Yuqing Zhang1, Christine Peloquin, Maureen Dubreuil,
Edward Roddy, Na Lu, Tuhina Neogi and Hyon K. Choi
Link...
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