Bariatric surgery could be indicated for gout in obese individuals

Bariatric surgery successfully lowers weight and serum uric acid (SUA) in obese patients with hyperuricaemia and gout, a study reports.

The study used the medical records of 147 patients with obesity who underwent weight-loss surgery. All of them had their body weight and SUA measured at baseline and after the procedure at week 1 and at months, 1, 3, 6, and 12.

A year after the surgery, the patients lost a mean of 30.7 kg (95 percent confidence interval [CI], 28.7–32.7) in weight (p<0.001).

SUA levels, on the other hand, rapidly fell from 419.0 µmol/l (95 percent CI, 400.1–437.8) at baseline to 308.4 µmol/l (95 percent CI, 289.6–327.2) in the first week following surgery. However, it flared to 444.8 µmol/l (95 percent CI, 423.9–465.6) at 1 month before decreasing again to 383.8 µmol/l (95 percent CI, 361.5–406.1) at 3 months, 348.9 µmol/l (95 percent CI, 326.3–371.5) at 6 months, and 327.9 µmol/l (95 percent CI, 305.3–350.5) at 12 months (p<0.001).

Results were consistent in the subgroup of 55 hyperuricaemia and 25 gout patients, with the improvements occurring more rapidly. Baseline SUA levels were above the therapeutic target (≥360 µmmol/l) in all gout patients, but the concentration dropped below this target at 12 months.

The mean reduction in SUA levels was 84.3 µmmol/l (95 percent CI, 63.1–105.4) overall and 163.6 µmmol/l (95 percent CI, 103.9–223.3) in the gout subgroup.

The present data suggest that gout may be considered as an indicator for weight-loss surgery in individuals with severe obesity.