J Korean Med Sci 2005; 20: 1029-33 ISSN 1011-8934 Copyright The Korean Academy of Medical Sciences The Prevalence of Metabolic Syndrome in Patients with Gout : A Multicenter Study It has been suggested that hyperuricemia and possibly gout are associated with the metabolic syndrome, but there have been no direct studies. This study was under- taken to obtain the prevalence of the metabolic syndrome in patients with gout and to compare it with those from the general population studies. This was a 4-institu- tional case-historical control study composed of 168 patients with gout. We assessed the prevalence of metabolic syndrome according to the ATP III criteria and compared the prevalence with that of the historical controls. To elucidate the factors in gout that were associated with metabolic syndrome, a multivariate analysis was done. The age-adjusted prevalence of metabolic syndrome in gout patients was 43.6%, which was significantly higher than that of the Korean control population (5.2%) from the previous studies. Patients with gout had more components of metabolic syn- drome than did the controls. Body mass index (BMI, OR=1.357 (95%CI 1.111-1.657)) and high density lipoprotein (HDL, OR=0.774 (95%CI 0.705-0.850)) were the vari- ables most significantly associated with the occurrence of metabolic syndrome in gout, but alcohol consumption did not show such associations. Gout is associated with the metabolic syndrome, and furthermore, obesity and dyslipidemia were the factors most associated with the syndrome in these patients. Key Words : Gout, Metabolic Syndrome X, Hyperuricemia Young Hee Rho, Seong Jae Choi*, Young Ho Lee, Jong Dae Ji, Kyung Mook Choi , Sei Hyun Baik , Seung-hie Chung , Chae-Gi Kim , Jung-Yoon Choe , Sung Won Lee , Won Tae Chung , Gwan Gyu Song* Division of Rheumatology, Korea University Anam Hospital; Division of Rheumatology, Korea University Guro Hospital*; Division of Endocrinology, Korea University Guro Hospital , Seoul; Division of Rheumatology, Catholic University of Daegu , Daegu; Division of Rheumatology, Dong-A University , Busan, Korea Received : 28 March 2005 Accepted : 23 June 2005 Address for correspondence Gwan Gyu Song, M.D. Division of Rheumatology, Korea University Guro Hospital, 80 Guro-dong, Guro-gu, Seoul 152-703, Korea Tel : +82.2-818-6667, Fax : +82.2-866-1643 E-mail : gsong@kumc.or.kr INTRODUCTION Gout is an inflammatory arthritis that is associated with hyperuricemia, and also is widely known to be associated with obesity, dyslipidemia, hyperglycemia and hypertension. Such metabolic abnormalities have recently been increasingly recognized as not being separate illnesses, but rather they are a clustered syndrome that has been termed the ‘‘metabolic syndrome’’ (1). Metabolic syndrome has gained significant attention through the ATP (Adult Treatment Panel) III guide- lines and it is considered to be an independent risk factor for cardiovascular diseases that is comparable to smoking. It has been suggested that hyperuricemia and possibly gout are associated with insulin resistance or with metabolic syn- drome (2-6), but no prevalence study has been done using the ATP III classification criteria. We recently conducted a single-center study (7) concerning this issue, and found the prevalence of metabolic syndrome with gout to be signifi- cantly higher than that in the general population (42.2% vs. 6.8%, gout vs. historical control, ATP III criteria used). This study is an expansion of our previous study with the purpose to discover the prevalence of the metabolic syndrome in pati- ents with gout and compare it with the historical controls. 1029 We also determined the factors associated with metabolic syndrome. MATERIALS AND METHODS This was a case-historical control study undertaken in four institutes; Korea University Anam and Guro Hospital, Daegu Catholic University Medical Center and Dong-A University Hospital. A total of 168 patients with gout were recruited and they were checked for the presence of metabolic syndrome according to the ATP III criteria (1). The presence of metabolic syndrome was defined as those patients having ≥3 of the following 5 parameters: a waist circumference >102 cm for males or >88 cm for females, serum triglyceride levels ≥150 mg/dL, serum HDL cholesterol levels <40 mg/dL for males or <50 mg/dL for females, systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg, and a fast- ing blood glucose ≥110 mg/dL. Those patients with pri- mary gout, as defined by the ACR preliminary criteria for the classification of acute gout (8), were included in the study, and patients with secondary gout (e.g., drug-induced or due to chronic renal failure) were excluded. As corticosteroid thera-