risk factors

Last edited 03/2021 and last reviewed 03/2023

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).   

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