While gout is usually associated with an elevated serum uric acid concentration, it can also occur with uric acid in the normal reference range.
A small percentage of patients with a low serum uric acid will develop gout.
Some patients with an elevated serum uric acid will not develop gout over 15 years.
According to Dalbeth et al (2018):
Serum Uric Acid
15-Year Cumulative Incidence
Hazard Ratio
< 6 mg/dL
1.1%
1
6.0 to 6.9 mg/dL
3.7%
2.7
7.0 to 7.9 mg/dL
9%
6.6
8.0 to 8.9 mg/dL
16%
15
9.0 to 9.9 mg/dL
35%
30
>= 10 mg/dL
49%
64
According to Robinson et al (2021):
<4 mg/dL
0.6%
4.0 to 4.49 mg/dL
1.3%
4.5 to 4.99 mg/dL
0.9%
5.0 to 5.49 mg/dL
5.5 to 5.99 mg/dL
1.5%
2.6
6.0 to 6.49 mg/dL
2.9%
3.7
6.5 to 6.99 mg/dL
3.2%
5.2
>= 7.00 mg/dL
12%
18.6
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Specialty: Surgery, orthopedic