Obesity Paradox in Recurrent Attacks of Gout in Observational Studies: Clarification and Remedy.

ABSTRACT:

Objective

Obesity is strongly associated with incident gout risk, but its association with the risk of recurrent gout attacks has been null or weak, constituting an obesity paradox. We sought to demonstrate and overcome the methodologic issues associated with the obesity paradox for risk of recurrent gout attacks.

Methods

Using the Multiple Risk Factor Intervention Trial database, we decomposed the total effect of obesity into its direct and indirect (i.e., mediated) effects using marginal structural models. We also estimated the total effect of body mass index (BMI) change from baseline among incident gout patients.

Results

Of 11,816 gout-free subjects at baseline, we documented 408 incident gout cases, with 132 developing recurrent gout attacks over a 7-year followu

SUBMITTER: Nguyen UD 

PROVIDER: S-EPMC5179319 | biostudies-literature | 2017 Apr

REPOSITORIES: biostudies-literature