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Does fat cause gout?

Numbers like overall weight and body mass index (BMI) may not tell the whole story, according to recent research looking at gout and visceral fat – the fat that builds up inside the abdomen. Too much visceral fat is linked to insulin resistance and development of type 2 diabetes – and gout.

A 2015 Arthritis Research & Therapy study found that people who were not obese as measured by BMI, but who had high levels of visceral fat, were more likely to have gout than their smaller-bellied counterparts (47.4% versus 27.3%). Gout patients with normal BMIs but high abdominal fat were also more likely than people without it (31.7% versus 13.2%) to have metabolic syndrome. The cluster of factors that make up this syndrome, which include abnormal cholesterol levels and high blood sugar, together increase the risk of heart disease, stroke and diabetes more than any one factor alone.

“Gout is not just an arthritis, but also a metabolic disease in which the primary metabolic problem is high uric acid,” says Dr. Khanna. “Like obesity and diabetes, high uric acid is a direct risk factor for cardiovascular disease and cardiac events.”