Serum urate-related genetic variants contribute to gout risk in people on diuretics

Serum urate (SU)-associated genetic variants have a robust impact on gout risk among individuals taking diuretics, with an effect comparable to those not taking the said agent, according to a recent study.

Using the UK Biobank Resource, the authors identified 359,876 participants and tested 10 SU-related single-nucleotide polymorphisms (SNP) for their association with gout according to diuretic use. Then, they examined gene-diuretic interactions for gout association using a genetic risk score (GRS) and individual SNP by logistic regression adjusting for relevant confounders.

Use of a loop diuretic showed a positive correlation with prevalent gout (odds ratio [OR], 2.34, 95 percent confidence interval [CI], 2.08–2.63) after adjustment, whereas thiazide diuretics exhibited an inverse association with prevalent gout (OR, 0.60, 95 percent CI, 0.55–0.66).

A higher GRS (≥ mean) positively correlated with gout in people not taking diuretics (OR, 2.63, 95 percent CI, 2.49–2.79), in those taking loop diuretics (OR, 2.04, 95 percent CI, 1.65–2.53), in those on thiazide diuretics (OR, 2.70, 2.26–3.23), and in those receiving thiazide-like diuretics (OR, 2.11, 95 percent CI, 1.37–3.25) relative to a lower GRS (< mean).

“These findings suggest that the contribution of genetic variants is not restricted to people with ‘primary’ gout, and that genetic variants can play an important role in gout susceptibility in the presence of other risk factors,” the authors said.