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Objective: The aim of this study was to examine whether serum urate-associated genetic variants are associated with early-onset gout., Methods: Participants with gout in the Genetics of Gout in Aotearoa study with available genotyping were included (n = 1648). Early-onset gout was defined as the first presentation of gout <40 years of age. Single nucleotide polymorphisms (SNPs) for the 10 loci most strongly associated with serum urate were genotyped. Allelic association of the SNPs with early-onset gout was tested using logistic regression in an unadjusted model and in a model adjusted for sex, body mass index, tophus presence, flare frequency, serum creatinine and highest serum urate. The analysis was also done in two replication cohorts: Eurogout (n = 704) and Ardea (n = 755), and data were meta-analysed., Results: In the Genetics of Gout in Aotearoa study, there were 638 (42.4%) participants with early-onset gout. The ABCG2 rs2231142 gout risk T-allele was present more frequently in participants with early-onset gout compared with the later-onset group. For the other SNPs tested, no differences in risk allele number were observed. In the allelic association analysis, the ABCG2 rs2231142 T-allele was associated with early-onset gout in unadjusted and adjusted models. Analysis of the replication cohorts confirmed the association of early-onset gout with the ABCG2 rs2231142 T-allele, but not with other serum urate-associated SNPs. In the meta-analysis, the odds ratio (95% CI) for early-onset gout for the ABCG2 rs2231142 T-allele was 1.60 (1.41, 1.83)., Conclusion: In contrast to other serum urate-raising variants, the ABCG2 rs2231142 T-allele is strongly associated with early-onset gout., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Fructose consumption has been linked with insulin resistance, obesity and diabetes, which are more prevalent in those of Māori or Pacific ethnicity compared to New Zealand European., Aim: To determine whether the acute effects of fructose consumption on serum glucose, insulin, lipids and C-reactive protein differs according to body mass index (BMI) and/or ethnicity., Methods: Participants of Māori (n = 25), Pacific (n = 26) or New Zealand European (n = 25) ethnicity consumed a 64 g fructose/16 g glucose solution. Changes in lipids, glucose, insulin and C-reactive protein were analysed using mixed models for repeated measures., Results: After adjustment for age and gender, those with higher BMI had a higher glucose (P = 0.0064) and insulin (P = 0.0007) response than those with lower BMI. Those of Māori or Pacific ethnicity had similar glucose levels (P = 0.077) to those of New Zealand European ethnicity but higher insulin responses (P = 0.0005), which remained after additional adjustment for BMI (P = 0.001). Reported sugar-sweetened beverages (SSB) intake was higher among Māori and Pacific than New Zealand European (median 1.0 vs 0.0 SSB/day P = 0.002)., Conclusion: Even after adjustment for BMI, those of Māori and Pacific ethnicity have a significantly higher insulin response to fructose than New Zealand Europeans. Higher habitual SSB intake may be a contributing factor., (© 2018 Royal Australasian College of Physicians.)

Aims: Disparities for Maori exist in New Zealand for cardiovascular risk factors, events and access to revascularisation. We compared characteristics and outcomes of coronary artery bypass grafting (CABG) between Maori and Europeans in New Zealand., Methods: Patients undergoing isolated CABG at Auckland City Hospital from July 2010-June 2012 were retrospectively analysed., Results: Of 818 patients, 82 were Maori and 444 were Europeans. Maori were younger (60.0 vs 67.9 years, p<0.001), had higher NZ deprivation index (8.5 vs 5.0, p<0.001), body mass index (32.6 vs 28.8 kg/m2, p<0.001), higher prevalence of heart failure (11.0% vs 2.3%, p<0.001), diabetes (43.9% vs 24.1%, p<0.001), smoking (39.0% vs 13.1%, p<0.001), dialysis (4.9% vs 0.9%, p=0.023), lower ejection fraction (p=0.001), lower additive EuroSCORE 1 (4.1 vs 4.8, p=0.041) and longer cardiopulmonary bypass time (100 vs 89 minutes p<0.001). Maori ethnicity was independently associated with 30-day mortality, odds ratio (OR) 6.35, 95% confidence interval 1.01-39.9, p=0.046; and surgical morbidity OR 2.05, 1.04-4.04, p=0.040. Maori had a trend for higher mortality at 1.4 plus or minus 0.6 years (hazards ratio 2.91, 0.92-9.20, p=0.069), 1-year mortality 6.3% vs 1.5%., Conclusion: Despite being younger, Maori undergoing CABG had more comorbidities and socioeconomic deprivation. Maori had higher mortality and complication rates. Maori should have earlier access to CABG.