Sleep patterns, genetic susceptibility, and risk of new-onset gout: The UK Biobank prospective cohort study

Objective: The association between sleep behaviors and gout risk remains uncertain. We aimed to evaluate the relationship of sleep patterns based on a combination of five major sleep behaviors with the risk of new-onset gout, and to explore whether genetic risks of gout may modify this association in the general population. Methods: 403,630 participants without gout at baseline in UK Biobank were included. A healthy sleep score was created by combining five major sleep behaviors, including chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. Genetic risk score for gout was calculated based on 13 single nucleotide polymorphisms (SNPs) with independently significant genome-wide association with gout. The primary outcome was new-onset gout. Results: During a median follow-up duration of 12.0 years, 4270 (1.1%) participants developed new-onset gout. Compared to participants with poor sleep patterns (0 <= healthy sleep score <= 1), those with healthy sleep patterns (4 <= healthy sleep score <= 5) had a significantly lower risk of new-onset gout (HR, 0.79; 95% CI: 0.70-0.91). Moreover, the significantly lower risk of new-onset gout associated with healthy sleep patterns were mainly found in those with low (HR, 0.68; 95%CI: 0.53-0.88), or intermediate genetic risks of gout (HR, 0.78; 95%CI: 0.62-0.99), but not in participants with high genetic risks of gout (HR, 0.95; 95%CI: 0.77-1.17) (P for interaction =0.043). Conclusions: Among the general population, a healthy sleep pattern was associated with a significant lower of new-onset gout risk, especially in those with lower genetic risks of gout.