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).
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.