Abstract
Gout affects more than 1% of adults in the USA, and it is the most common form of inflammatory arthritis among men. Accumulating data support an increase in the prevalence of gout that is potentially attributable to recent shifts in diet and lifestyle, improved medical care, and increased longevity. There are both nonmodifiable and modifiable risk factors for hyperuricemia and gout. Nonmodifiable risk factors include age and sex. Gout prevalence increases in direct association with age; the increased longevity of populations in industrialized nations may contribute to a higher prevalence of gout through the disorder's association with aging-related diseases such as metabolic syndrome and hypertension, and treatments for these diseases such as thiazide diuretics for hypertension. Although gout is considered to be primarily a male disease, there is a more equal sex distribution among elderly patients. Modifiable risk factors for gout include obesity, the use of certain medications, high purine intake, and consumption of purine-rich alcoholic beverages. The increasing prevalence of gout worldwide indicates that there is an urgent need for improved efforts to identify patients with hyperuricemia early in the disease process, before the clinical manifestations of gout become apparent.
Highlights
Assessing the incidence and prevalence of gout is challenging because of its episodic nature
Male veterans are at heightened risk for developing gout because of their numerous risk factors, as seen in the Normative Aging Study conducted by the US Department of Veterans Affairs (Fig. 1) [1]
Advancing age increases the prevalence of gout; this is partly attributable to the increased risk factors for gout – including metabolic syndrome, hypertension, and renal disease – that are associated with age
Summary
Assessing the incidence and prevalence of gout is challenging because of its episodic nature. Adding to the strength of these findings, a subsequent investigation by Choi and Curhan [34] evaluated the relationship between intakes of beer, liquor, and wine and serum uric acid levels using data from 14,809 participants in the Third National Health and Nutrition Examination Survey (NHANES) Both before and after adjustment for other risk factors for hyperuricemia, beer and liquor intake was positively associated with increased serum urate levels (P for trend < 0.001). (LIFE) study [45], baseline serum uric acid levels were associated with a 1.02-fold increase in the risk for cardiovascular events per 10 μmol/l increase; this association was significant in women but not in men. Because vitamin C is generally considered safe, its uricosuric effect may provide a potentially useful option for the prevention and management of hyperuricemia and gout
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