Longitudinal Changes in Serum Urate Levels From Premenopause Through Postmenopause: Interrupted Time-Series Analyses
Shreya Billa1, Sho Fukui1,2,3, Misti L Paudel1
1Division of Rheumatology, Inflammation, and Immunity, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis & Rheumatology (Hoboken, N.J.)
|October 3, 2025
Summary
Serum urate (SU) levels significantly rise during menopause, increasing hyperuricemia (HU) risk in post-menopausal women. Maintaining healthy weight and kidney function before menopause may prevent HU and gout.
Area of Science:
- Endocrinology
- Nephrology
- Rheumatology
Background:
- Hyperuricemia (HU) and gout are prevalent in post-menopausal women.
- Understanding longitudinal serum urate (SU) changes during menopause is crucial for prevention strategies.
Purpose of the Study:
- To identify longitudinal changes in SU levels during and after menopause.
- To investigate the interaction of SU changes with SU-modifying conditions.
Main Methods:
- Longitudinal study of Japanese women with annual medical examinations.
- Categorization of menopausal stages: pre-menopause, peri-menopause, and post-menopause.
- Interrupted time-series analyses to examine SU and HU changes, with subgroup evaluations.
Main Results:
- SU levels increased gradually in pre-menopause, sharply in peri-menopause, and stabilized post-menopause.
- Post-menopausal SU levels were 0.41 mg/dL higher than pre-menopausal levels.
- HU prevalence rose from <1.0% to 4-5% post-menopause; overweight/obesity amplified HU risk.
Conclusions:
- Serum urate levels increase rapidly during peri-menopause, leading to elevated levels by menopause.
- Maintaining normal body weight and kidney function before menopause may reduce postmenopausal HU and prevent gout.
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