Arthritis Res Ther. 2025 Dec 26. doi: 10.1186/s13075-025-03716-3. Online ahead of print.
ABSTRACT
BACKGROUND: The influence of physical activity (PA) patterns on gout risk is unclear. We investigated the associations of accelerometer-derived PA patterns, specifically regularly active (RA) and weekend warrior (WW), with incident gout.
METHODS: We analyzed 97,387 gout-free UK Biobank participants with 7-day wrist-worn accelerometer data. Participants were categorized as inactive (< 150 min/week moderate-to-vigorous PA [MVPA]), WW (≥ 150 min MVPA with ≥ 50% concentrated in 1-2 days), or RA (≥ 150 min MVPA, not meeting WW criteria). Multivariable Cox models estimated hazard ratios (HRs) for incident gout.
RESULTS: During a median 8.0 years’ follow-up, 833 gout cases occurred. In minimally adjusted models, both RA (HR = 0.67, 95% CI: 0.55-0.83, P < 0.001) and WW (HR = 0.76, 95% CI: 0.65-0.89, P < 0.001) patterns showed reduced risk compared to inactive pattern. However, results diverged after further adjustment for baseline sUA: the RA pattern maintained a robust protective association (HR = 0.79, 95% CI: 0.65-0.98, P = 0.029), whereas the association for the WW pattern was attenuated and lost statistical significance (HR = 0.93, 95% CI: 0.79-1.08, P = 0.331). Subgroup analyses revealed significant interactions with comorbidities (P for interaction < 0.01), where the WW pattern showed no inverse association in participants with hypertension or chronic kidney disease, while RA remained protective. These findings were robust across sensitivity analyses and genetic risk strata.
CONCLUSION: While any moderate-to-vigorous physical activity is beneficial, the regularly active pattern demonstrates a more robust inverse association with gout than the weekend warrior pattern. Regularity in physical activity appears crucial for gout risk reduction, particularly for metabolically vulnerable individuals, as the sporadic nature of the weekend warrior pattern may be insufficient to counteract established metabolic risks.
PMID:41454374 | DOI:10.1186/s13075-025-03716-3
