Study population

We used data from the Singapore Chinese Health Study (SCHS), a population-based cohort of 63,257 Chinese adults aged 45–74 years at enrolment (1993–1998)¹⁷. The participants were recruited from two major Chinese dialect groups in Singapore, the Hokkien and Cantonese. Trained interviewers conducted the face-to-face interviews in participants’ homes at recruitment, and obtained the information on demographics, height, weight, tobacco use, physical activity, dietary habits and medical history. Two follow-up interviews were conducted via telephone among surviving participants between 1999 and 2004, and again between 2006 and 2010 to update information on selected lifestyle factors and medical history. The study was approved by the institutional review board of the National University of Singapore, and the study was carried out in accordance with the approved guidelines. All participants have given informed consents.

We used the follow-up I interview (1999–2004) as baseline for our analysis because both gout and diabetes were enquired at this time among 52,322 surviving participants who participated in this interview. During the follow-up II interview (2006–2010), 39,528 participants were re-contacted and information on gout and diabetes was updated.