Risk factors

Hyperuricaemia is the main risk factor for the development of gout (1).

• 5-yr cumulative risk of developing gout was
  • 30.5% in those with a serum uric acid (SUA) level ≥0.6 mmol/l (≥10 mg/dl)
  • only 0.6% in those with an SUA <0.42 mmol/l (<7.0 mg/dl) (1)

There are several factors which are associated with hyperuricemia and gout (2).

• age
  • important in both men and women
  • age of onset of gout is inversely related to the SUA (1)
• gender
  • urate levels are higher in men than in women and also an increased risk in prevalence in gout at all ages
  • gout occurs rarely in young females (due to uricosuric effect of oestrogen)
• osteoarthritis (OA)
• genetics
  • although rare, primary gout in men often shows strong familial predisposition (2)
  • a recent clinical study has shown that tissue changes occurring in OA may support local deposition of MSU crystals
• diet
  • an increased risk was associated with a high red meat diet and a higher consumption of seafood
  • lower risk was associated with diets high in low-fat dairy
• alcohol
• drugs
  • loop and thiazide diuretics - is considered to be the most common modifiable risk factors for secondary gout especially in the elderly and in women
  • a high dose asprin of >3000 mg/day is uricosuric.So,opt for low dose asprin.
• the metabolic syndrome
• obesity
• renal insufficiency
• hypertension
• congestive heart failure (3).

Reference:

• (1) Jordan KM et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-4
• (2) Doherty M. New insights into the epidemiology of gout. Rheumatology (Oxford). 2009;48 Suppl 2:ii2-ii8.
• (3) Neogi T. Clinical practice. Gout. N Engl J Med. 2011 Feb 3;364(5):443-52.