Bariatric surgery could be indicated for gout in obese individuals

13 Jan 2021
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.

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