Isolated, metabolic and hypertensive gout: a population-based cluster analysis of 94 759 patients
Authors' conclusion
Gout manifests in three clearly differentiated clinical phenotypes, each potentially reflecting a distinct predominant aetiology of hyperuricaemia (isolated/genetic, insulin-resistance-mediated, or renal-vascular).
Study context
- Population
- Patients with incident gout (2012–23), SIDIAP database (Catalonia, Spain)
- Participants
- 94,759 patients
- Exposure
- Clinical phenotype clusters of incident gout
- Outcome
- Identification of distinct clinical phenotypes (clusters) by demographics and major comorbidities
Methodological detailspopulation-based, cluster analysis (K-prototypes algorithm)
- Population-based
- Cluster analysis (K-prototypes algorithm)
Main finding
As reported in the abstract
Cluster distribution
| Group | Value | Mean age | Type 2 diabetes prevalence | Obesity |
|---|---|---|---|---|
| Cluster 1 | 37.0% | 54 | ||
| Cluster 2 | 22.8% | 74 | 100% | 51.3% |
| Cluster 3 | 40.2% |
Value
Cluster 137.0%
Cluster 222.8%
Cluster 340.2%
Mean age
Cluster 154
Cluster 274
Cluster 3— not stated in the abstract
Type 2 diabetes prevalence
Cluster 1— not stated in the abstract
Cluster 2100%
Cluster 3— not stated in the abstract
Obesity
Cluster 1— not stated in the abstract
Cluster 251.3%
Cluster 3— not stated in the abstract
Observational data: associations, not effects.
Further findings
Sustained serum urate (SU) control (SU <6 mg/dl for ≥80% of follow-up)
- Overall, only 12% of patients achieved sustained SU control
- Cluster 1 showed the highest SU control
Urate-lowering therapy (ULT) prescription and adherence (Medication Possession Ratio)
- Cluster 2 had higher ULT prescription rates
- Cluster 1 showed better adherence
Original publication
Isolated, metabolic and hypertensive gout: a population-based cluster analysis of 94 759 patients. Rheumatology (Oxford). Published 12 August 2026. doi:10.
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