Wei Sitong, Zhang Jie, Ren Shaoguang, Ye Dongqing, Fang Xinyu
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
PLoS One. 2025 Jul 14;20(7):e0326052. doi: 10.1371/journal.pone.0326052. eCollection 2025.
Accumulating evidence suggests that domestic hard water is linked to health outcomes, but whether there is a potential association with gout is unknown.To examine the association between domestic hard water and gout incidence and recurrence in adults aged 40-69 years from the UK Biobank.
We analyzed a cohort of 448,510 participants free of gout at baseline (2006-2010) for incidence analysis and 7,231 participants with prevalent gout for recurrence. Domestic water hardness data were obtained from local water supply companies across England, Wales and Scotland in 2005 and 2013. Cox proportional hazard models were used to assess the association between water hardness and both gout incidence and recurrence. Additionally, the Cochran Armitage test was used to examine the linear trend and restricted cubic splines assessing nonlinear relationships.
During a median follow-up of 13.29 years, 6,521 incident events were recorded, and at a median 12.40 years, 519 gout recurrence events were identified. For incidence, compared with individuals exposed to 0-60 mg/L, the HRs (95% CIs) for the incidence of gout in the other three grades were 1.12 (1.05-1.19), 1.16 (1.05-1.29) and 1.18 (1.11-1.25), respectively. Each additional 50 mg/L of CaCO3, Ca and Mg increased gout risk (HRs [95% CIs] were 1.04 [1.03-1.05], 1.17 [1.13-1.20] and 1.99 [1.46-2.71], respectively). In addition, CaCO3, Ca and Mg demonstrated the nonlinear relationship with gout incidence (all p for nonlinearity<0.05). For recurrence, each additional 50 mg/L of Mg increased gout recurrence risk (HRs [95% CIs] was 2.97 [1.11-7.97]). And linear trend test shown was significant for Mg (P for trend = 0.03026).
The results revealed that exposure to hard water characterized by higher concentration levels of CaCO3, Ca and Mg might increase the risk of gout incidence. Moreover, individuals who are subjected to higher Mg concentrations might increase the risk of gout recurrence.
越来越多的证据表明，家庭硬水与健康结果有关，但与痛风是否存在潜在关联尚不清楚。本研究旨在探讨英国生物银行中40-69岁成年人家庭硬水与痛风发病率及复发率之间的关联。
我们分析了一个队列，其中448,510名参与者在基线时（2006-2010年）无痛风，用于发病率分析；7,231名患有痛风的参与者用于复发分析。2005年和2013年从英格兰、威尔士和苏格兰的当地供水公司获取家庭水硬度数据。采用Cox比例风险模型评估水硬度与痛风发病率及复发率之间的关联。此外，使用 Cochr an Armitage检验来检验线性趋势，并使用受限立方样条来评估非线性关系。
在中位随访13.29年期间，记录了6,521例发病事件，在中位随访12.40年时，确定了519例痛风复发事件。对于发病率，与暴露于0-60mg/L的个体相比，其他三个等级的痛风发病率的HR（95%CI）分别为1.12（1.05-1.19）、1.16（1.05-1.29）和1.18（1.11-1.25）。碳酸钙、钙和镁每增加50mg/L，痛风风险增加（HR[95%CI]分别为1.04[1.03-1.05]、1.17[1.13-1.20]和1.99[1.46-2.71]）。此外，碳酸钙、钙和镁与痛风发病率呈非线性关系（所有非线性p<0.05）。对于复发，镁每增加50mg/L，痛风复发风险增加（HR[95%CI]为2.97[1.11-7.97]）。镁的线性趋势检验显示有统计学意义（趋势p=0.03026）。
结果显示，暴露于以碳酸钙、钙和镁浓度较高为特征的硬水可能会增加痛风发病风险。此外，镁浓度较高的个体可能会增加痛风复发风险。
