Female Gout Research Articles

The Evolving Landscape of Gout in the Female: A Narrative Review

Gout is at least three times more prevalent in males than in females. However, concurrent with rising total gout prevalence, complex factors, including comorbidities, diet, lifestyle, and aging, have promoted higher gout prevalence in females. This narrative review focuses on summarizing recent developments in the landscape of gout in females and the mechanisms involved. New knowledge on sex hormone effects on both urate-excreting and urate-reabsorbing transporters and higher hypertension and chronic kidney disease prevalence in females compared to males may help explain why gout incidence rises robustly after menopause in females, to approach that in males. Racial and ethnic factors, risk profiles based on heritable genetic polymorphisms of urate transporters, diet, body mass index, and lifestyle factors differ according to sex. In addition, sex differences in clinical phenotypes, outcomes of gout, and non-gout illnesses include more frequent comorbidities, more pain and disability during gout flares, different perceptions of disease burden, and more frequent severe cutaneous hypersensitivity reaction to allopurinol in females. Collectively, such findings support the potential clinical benefits of tailoring gout and hyperuricemia treatment according to sex.

Filling gaps in female gout: a cross-sectional study of comorbidities in 192 037 hospitalised patients

ObjectiveThere is room for improvement in the knowledge of female gout, often noted at risk of gender blindness. This study aims to compare the prevalence of comorbidities in women versus...

Interactions Between Genetic Risk and Diet Influencing Risk of Incident Female Gout: Discovery and Replication Analysis of Four Prospective Cohorts.

To examine whether the cross-sectional gene-diet interaction for prevalent hyperuricemia among women translates prospectively to risk of incident female gout. We analyzed the interaction between genetic predisposition and adherence to a healthy dietary pattern (i.e., Dietary Approaches to Stop Hypertension [DASH] score) on risk of incident female gout in 18,244 women from Nurses' Health Study (NHS; discovery) and 136,786 women from 3 additional prospective female cohorts from the US and UK (replication). Genetic risk score (GRS) was calculated from 114 urate-associated loci. In the NHS and replication cohorts, association between diet and gout risk was larger and stronger among women with higher genetic risk. In all cohorts combined, compared to women with an unhealthy DASH score (less than the mean score), multivariable relative risk (RR) for incident gout among women with a healthy DASH score (greater than/equal to the mean score) was 0.67 (95% confidence interval [95% CI] 0.60-0.76) among higher GRS (greater than/equal to the mean score) and 0.91 (0.78-1.05) among lower GRS (P for multiplicative interaction=0.001); multivariable RR for higher versus lower GRS was 2.03 (95% CI 1.80-2.29) and 1.50 (95% CI 1.31-1.71) among unhealthy and healthy DASH score groups, respectively. Additive interaction was also significant, in both the discovery and replication cohorts (P < 0.001), with 51% of the excess risk attributable to the additive gene-diet interaction in all cohorts combined. The deleterious effect of genetic predisposition on risk of incident female gout was more pronounced among women with unhealthy diets, with nearly half the excess risk attributable to this gene-diet interaction. These data elucidate the important synergy of genetics and diet for female gout development.

Prevalence of motor neuron diseases in gout patients: a nationwide population-based cohort study.

Increased uric acid may have a protective effect in motor neuron diseases (MNDs). The association between gout, characterized by hyperuricemia, and MNDs was not investigated previously. To estimate the prevalence of MNDs in gout patients using the Health Insurance and Review Assessment (HIRA) database, a nationwide database of South Korea. The current descriptive study was conducted using the HIRA database. Subjects diagnosed with gout from 2011 to 2018 were included in this study. Among them, the annual prevalence of MNDs was analyzed, stratified by age and sex. Comorbidities including the Charlson Comorbidity Index score and type of prescribed gout-related drug were also demonstrated. The age-adjusted prevalence of MNDs per 105 persons ranged from 0.598 (95% confidence interval (CI): - 0.231-1.426) to 2.534 (95% CI: 1.100-3.968) between 2011 and 2018. Compared to previous reports, the prevalence of MNDs, especially amyotrophic lateral sclerosis (ALS), in gout patients was significantly lower than in the general population. None of the female gout patients were diagnosed with MNDs. Cerebrovascular accidents, vascular risk factors including hypertension, dyslipidemia, and diabetic complications, and the use of uric acid-lowering agents were more common in gout patients with MNDs than in those without MNDs. This study adds to the evidence of MND prevalence in gout patients. Gout might have a protective effect against the risk of MNDs.

Associations of habitual glucosamine supplementation with incident gout: a large population based cohort study

ObjectivesThe association between habitual glucosamine use and incident gout has not been examined in previous studies. We aimed to evaluate the association of habitual use of glucosamine with the risk of gout in general population.MethodsA total of 436,594 participants (55.4% female) without prior gout at baseline who completed a questionnaire on supplementation use, which included glucosamine, in the UK Biobank were enrolled. Incident gout was recorded from self-report, death register, primary care, and hospital admission data.ResultsAt baseline, 53,433 (22.1%) females and 30,685 (15.8%) males reported habitual glucosamine use. During a median follow-up period of 12.1 years, 1718 (0.7%) females and 5685 (2.9%) males developed gout. After multivariable adjustment for major risk factors, glucosamine use was associated with a significantly lower risk of incident gout in females (hazard ratio [HR], 0.81, 95% confidence interval [CI], 0.71–0.92), but not in males (HR, 1.05, 95% CI, 0.97–1.13), compared with non-use (P-interaction < 0.001). Among females, the inverse association between glucosamine use and gout was stronger in participants with diuretics use (HR, 0.64, 95% CI, 0.50–0.81) than those without diuretics use (HR, 0.89, 95% CI, 0.77–1.03) (P-interaction = 0.015). Moreover, gout genetic risk scores did not significantly modify the association between glucosamine use and the risk of incident gout in males (P-interaction = 0.548) or females (P-interaction = 0.183).ConclusionsHabitual glucosamine use to relieve osteoarthritis pain was related to lower risk of gout in females, but not in males.

Genetic contributions to female gout and hyperuricaemia using genome-wide association study and polygenic risk score analyses.

To identify genetic variants and polygenic risk score (PRS) relating to female gout and asymptomatic hyperuricaemia (AH) in a genome-wide association study (GWAS). Gout, AH and normouricemia controls were included from Taiwan biobank and China Medical University Hospital. All participants were divided into discovery and replication cohorts for GWAS. PRS was estimated according to whether the variant exhibited a protective effect on the phenotypes or not. Each cohort was separated into two groups by the age of 50 years old. A total of 59 472 females were enrolled, and gout and AH occupied 1.60% and 19.59%, respectively. Six variants located in genes SLC2A9, C5orf22, CNTNAP2 and GLRX5 were significantly predictors of female gout in those aged ≥50. For those aged <50 years old, only the variant rs147750368 (SPANXN1) on chromosome X was found. Most variants located in genes SLC2A9, ZNF518B, PKD2 and ABCG2 were found to be significantly related to AH in both age groups. The PRS could explain ∼0.59% to 0.89% of variance of gout in variants with protective effects, which showed 6.2 times of mean PRS in the risk variants, but only 1.2 times in the AH phenotype. Moreover, the PRS also revealed a dose-response trend between AH rates and quartile scores. The variants in gene SLC2A9 are the major genetic factors for females associated with gout in those aged ≥50. PRS can provide a more robust prediction of the gout/AH under a homogeneous selection of variants that show effects on the traits.

Renal impairment in gout: females vs. males (clinical case)

Objectives. Clinical and paraclinical evolution of gout in males and females. Materials and methods. Description of two clinical cases with gout and renal involvement, one male and one female, which were hospitalized in the „Timofei Mosneaga” Republican Clinical Hospital and Municipal Clinical Hospital „Saint Trinity” in 2021. Results. The male patient was hospitalized in a serious condition, being drowsy, disoriented and with bradyphrenia. Patient complained of dyspnea at mild exertion, severe fatigue, 5-day anuria and generalized edema. From the history collected from relatives, it was discovered that the patient has been diagnosed with gout a few years ago. The female patient has been hospitalized in the Nephrology department of the Republican Clinical Hospital „Timofei Moşneaga” for comprehensive evaluation. Her complaints: low back pain, dysuria, nocturia, moderate ankle edema, oliguria, marked asthenia, paresthesia. Conclusions. In women, primary renal damage is more common until the onset of menopause. After the onset of menopause, there is primarily joint damage, then kidney damage, or this process develops simultaneously (kidney and joint damage). In males due to hyperuricemia, there is joint damage, which later is associated with gouty nephropathy or kidney and joint involvement evolve paralleled.

Managing Gout in Women: Current Perspectives.

Gout is a common inflammatory arthritis that tends to affect significantly more men than women. However, female gout patients are more likely to have comorbidities such as hypertension, diabetes mellitus, and renal dysfunction. Furthermore, they experience a greater disease burden due to gout than males. While nonbiological causes may possibly contribute to this sex discrepancy in burden, this raises questions regarding whether current gout pharmacotherapies are as efficacious in females as they are in males. In this review, we examine how the clinical profile of female gout patients differs from male patients; we then survey the literature for data on outcomes for female gout patients treated with urate-lowering therapies for chronic management of gout as well as commonly used agents for acute flares. We also discuss considerations for managing gout in women during pregnancy and lactation.

Adherence to 2020 to 2025 Dietary Guidelines for Americans and the Risk of New-Onset Female Gout

Female-specific gout data are scarce despite perceived differences from males in its risk factors and disproportionate worsening in disease and comorbidity burden globally. The 2020 to 2025 Dietary Guidelines for Americans recommend multiple healthy eating patterns for prevention of cardiovascular-metabolic outcomes, which may also be relevant to the prevention of female gout. To examine the associations of dietary scores for the latest guideline-based healthy eating patterns with risk of incident female gout. This prospective cohort study included 80 039 US women in the Nurses' Health Study followed up through questionnaires every 2 years starting from 1984. Participants had no history of gout at baseline, and the study used questionnaire responses through 2018. Statistical analyses were performed over September 2020 to August 2021. Four healthy eating patterns: Dietary Approaches to Stop Hypertension (DASH), Alternate Mediterranean Diet Score, Alternative Healthy Eating Index (AHEI), and Prudent, plus Western (unhealthy) for comparison, with scores derived from validated food frequency questionnaires. Incident, physician-diagnosed female-specific gout. During 34 years of follow-up, we documented 3890 cases of incident female gout. Compared with the least-adherent quintile, women most adherent to healthy diets had significantly lower risk of incident gout, with multivariable-adjusted hazard ratios (HRs) 0.68 (95% CI, 0.61-0.76) (DASH), 0.88 (95% CI, 0.80-0.98) (Mediterranean), 0.79 (95% CI, 0.71-0.89) (AHEI), and 0.75 (95% CI, 0.73-0.90) (Prudent); all P for trend ≤.009. Conversely, women with highest-quintile Western diet score had 49% higher risk of gout (HR, 1.49; 95% CI, 1.33-1.68], P <.001). When combined, the most DASH-diet adherent women with normal body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) had a 68% lower risk of gout compared with the least adherent women with overweight or obese BMI; the corresponding risk reduction was 65% combining high DASH diet adherence with no diuretic use. These large-scale, long-term prospective cohort findings extend the pleotropic benefits of the 2020 to 2025 Dietary Guidelines for Americans to female gout prevention, with multiple healthy diets that can be adapted to individual food traditions, preferences, and comorbidities.

Impact of adiposity on risk of female gout among those genetically predisposed: sex-specific prospective cohort study findings over >32 years

ObjectivesTo evaluate the joint (combined) association of excess adiposity and genetic predisposition with the risk of incident female gout, and compare to their male counterparts; and determine the proportion attributable...

Association between female reproductive factors and gout: a nationwide population-based cohort study of 1 million postmenopausal women

BackgroundPrevious studies have shown that the incidence and risk factors of gout differs according to sex. However, little research has been done on the association between reproductive factors and gout. We conducted an analysis of a large nationwide population-based cohort of postmenopausal women to determine whether there is an association between reproductive factors and the incidence of gout.MethodsA total of 1,076,378 postmenopausal women aged 40–69 years who participated in national health screenings in 2009 were included in the study. The outcome was the occurrence of incident gout, which was defined using the ICD-10 code of gout (M10) in the claim database. Cox proportional hazard models were used for the analyses and stratified analyses according to body mass index (BMI) and the presence/absence of chronic kidney disease (CKD) were performed.ResultsThe mean follow-up duration was 8.1 years, and incident cases of gout were 64,052 (incidence rate 7.31 per 1000 person-years). Later menarche, earlier menopause, and a shorter reproductive span were associated with a high risk of gout. No association between parity and gout incidence was observed. Use of oral contraceptives (OC) and hormone replacement therapy (HRT) were associated with an increased risk of gout. The association between reproductive factors and gout was not statistical significant in the high BMI group. The effects of OC and HRT usage on gout were not significant in the CKD group.ConclusionShorter exposure to endogenous estrogen was associated with a high risk of gout. Conversely, exposure to exogenous estrogen such as OC and HRT was associated with an increased risk of gout.

Galectin-3 in patients with atrial fibrillation and restored sinus rhythm

Cardiac fibrosis is the hallmark of atrial remodeling in atrial fibrillation. Galectin-3 (Gal-3) is a biomarker of fibrosis. It is well studied in heart failure, but the data about its role in atrial fibrillation are sparse. The aim of the study was to evaluate the levels of Gal-3 in patients with atrial fibrillation after sinus rhythm restoration, to examine the association between this biomarker and other factors for developing atrial fibrillation and to assess its prognostic role. We included 67 patients (35 male) at the mean age of 67.36±7.25 years, with Gal-3 test after sinus rhythm restoration, a subgroup of participants in placebo-controlled randomized clinical trial of treatment with spironolactone. They were followed up for atrial fibrillation recurrence and hospitalizations. The effect of demographic parameters and other factors on Gal-3 levels were evaluated before and one year after treatment. Mean Gal-3 at baseline was 16.9±6.8 ng/ml. Higher levels of Gal-3 were associated with female gender (р=0.008), increasing age (р=0.005), renal dysfunction (p<0.0001) and gout (р=0.002). Higher thromboembolic risk as assessed by CHA2DS2-VASc score was significantly related to Gal-3. The levels of biomarker did not affect the number of atrial fibrillation recurrences (p=0.9) and hospitalizations. No correlation was found with treatment with spironolactone, antiarrhythmic and antihypertensive drugs. Higher Gal-3 in atrial fibrillation was associated with female sex, renal dysfunction, and history of gout. The levels of Gal-3 were not related to rhythm control. Treatment with spironolactone did not affect the biomarker of fibrosis Gal-3 in AF patients. Higher Gal-3 was related to high embolic risk.

Short Term Effectiveness of Intraatricular Injection of Methylprednisolone Acetate in Subacromial Impingement Syndrome in a tertiary care hospital.

Objective: To determine mean decrease in VAS pain score of intraarticular injection of methyl prednisolone acetate in patients of subacromial impingement syndrome. Methods: Its Descriptive Case Series/ Quasi experimental study. Study was conducted in department of Orthopedics Unit- I, Jinnah hospital Lahore. Study completed in Six months i.e. from June 2014 to December 2014.After taking an informed consent, 70 newly diagnosed cases of Subacromial impingement syndrome by history and examination (described by the patient as pain in subacromial space when the humerus was elevated or internally rotated and tested by having the patient place his hand on the unaffected shoulder and gradually forward flexing the shoulder (positive impingement sign)which have not received any kind of treatment were included. Results: Effectiveness of intraarticular injection of methyl prednisolone acetate was measured on visual analogue scale (VAS) from 0 to 10 by VAS score after 6 weeks. 70 patients with mean age of 36.2 ± 10.6 years were included. 61 patients (75.7%) were male, 10 patients (14.3%) had gout and 20% were diabetic. Mean pretreatment VAS score was 5.03 ± 1.58 while mean post-treatment VAS score was 3.86 ± 0.839. Mean reduction was 1.17 ± 1.57 ranged from 2 to 6. There was non-significant association of age and diabetes with mean reduction in VAS score while female gender and gout were significantly and negatively associated with treatment outcome. It is concluded that mean reduction in VAS score after 6 weeks of treatment of subacromial impingement syndrome after intra articular methylprednisolone injection is 1.17 ± 1.57 and acceptable. Conclusion: It is concluded that intraatricular injection of methyl prednisolone injection is efficacious and effective for treatment of Subacromial impingement syndrome in Pakistani population. Keyword: subacromial impingement syndrome, intra articular methylprednisolone injection, visual analogue scale, effectiveness.

Socioeconomic differences in hyperuricemia and gout: a systematic review and meta-analysis.

There are multiple risk factors have different influence on the disorder. However, the risk of hyperuricemia and gout in different socioeconomic status (SES) remains unclear. Recent studies provided results that contradicted to former studies. We aimed to perform a systematic review and meta-analysis of evidence to date and to assess the associations between SES and hyperuricemia or gout worldwide. We searched MEDLINE, EMBASE, and Web of Science databases to identify studies that investigated the association between SES and hyperuricemia or gout. Studies that presented risk estimates were included. We conducted meta-analyses using random effects to combine unadjusted and adjusted effect estimates. Data from 14 studies were included, 9 provided data about hyperuricemia and 5 provided gout. Overall, there was an association between higher educational level and a higher risk of hyperuricemia (POR = 1.38, 95% CI 1.04-1.73) but lower risk of gout (POR = 0.59, 95% CI 0.47-0.71). Subgroup meta-analysis showed no association between all SES measures and hyperuricemia or gout in males or females. Our study suggested that the associations between SES and hyperuricemia gout are different. Higher educational level was related to a higher risk of hyperuricemia but lower risk of gout. Given the limitations of our study, future studies are needed to investigate specific mechanisms underlying the relationship among SES differences in hyperuricemia and gout. Strategies to prevent and control SES inequalities in hyperuricemia and gout should be explored and adopted.

Risk of Thyroid Disorders in Patients with Gout and Hyperuricemia.

The risk of thyroid autoimmunity and thyroid dysfunction among patients with gout and hyperuricemia has not been well defined. This study was undertaken to examine the impact of gout and hyperuricemia on risk of thyroid disorders including thyroid autoimmunity and thyroid dysfunction. A population-based cross-sectional study was conducted to assess the risk of thyroid autoimmunity and thyroid dysfunction related to gout and hyperuricemia, which included 115 gout patients, 439 hyperuricemic patients, and 2 254 individuals without gout and hyperuricemia. A systematic review and meta-analysis of 14 observational studies was also done to systematically evaluate the risk of thyroid dysfunction among patients with gout and hyperuricemia. Findings from the cross-sectional study suggested a significantly increased risk of hypothyroidism among female gout patients (OR=2.44, 95% CI 1.15-5.17, p=0.02). Besides, gout could also substantially increase risk of Hashimoto's thyroiditis in women (OR=3.15, 95% CI 1.53-6.49, p=0.002). The meta-analysis proved a considerably increased risk of hypothyroidism among both gout patients (OR=1.51, 95% CI 1.23-1.85, p<0.001) and hyperuricemic patients (OR=1.34, 95% CI 1.11-1.61, p=0.002). Moreover, this meta-analysis also suggested that gout could also significantly increase the risk of hyperthyroidism (OR=1.25, 95% CI 1.06-1.48, p=0.01). The findings from the study suggest increasing risk of hypothyroidism and Hashimoto's thyroiditis among gout patients. Moreover, gout but not hyperuricemia is linked to increased risk of hyperthyroidism. More studies are warranted to elucidate the influence of gout and hyperuricemia on thyroid disorders.

Differential risk group of developing stroke among older women with gouty arthritis: A latent transition analysis.

Gout-related comorbidities are intricate and its clinical features may demonstrate sex difference; however, few studies have evaluated the links between comorbidities and gout in a female population. The objectives of this study were to compare the aggregation and transitive trajectories of comorbidities of gout, and their consequences in female and male gout populations. A prospective cohort study was conducted using data from the Taiwan National Health Insurance Research Database. A female and male gout population were followed up from 2000 to 2009 to identify the comorbidities of cardiovascular disease, hyperlipidemia, hypertension, diabetes mellitus (DM) and chronic kidney disease. The cumulative incidence of stroke from 2000 to 2010 was examined. A latent trajectory analysis was used to determine the transitive trajectories of the comorbidities of gout. Both female and male patients with gout had five risk cluster transition (CT) phenotypes of comorbidities within 10-year follow-up: CT1 and CT2, with various persistent comorbidities; CT3, with few persistent comorbidities; and CT4 and CT5, with transfer to cluster 1 from other clusters. The female participants in CT2 predominantly experienced DM and were associated with significantly increased risk of developing stroke. Diabetes is a notable risk factor for the development of stroke in female patients with gout. Early assessment and management for the comorbidities of gout, particularly in DM, would effectively reduce future stroke risk in female gout population.

Analysis of clinical characteristics of patients with gout at different onset ages

According to the onset age, a total of 5 674 outpatients with gout admitted in the affiliated hospital of Qingdao University from January 2011 to January 2016 were divided into youth group (≤44 years, n=3 058), middle age group (45~64 years, n=2 101), and elderly group (≥65 years, n=515). Their clinical and biochemical characteristics were analyzed. The results showed that the proportion of gout in the males in three groups was higher than that in the females. The proportions of gout in male youth, middle age, and elderly groups were 98.1%, 93.4%, and 83.1%, respectively. The proportion of gout in females increased with age. The proportion of gout family history in youth group was higher than that in middle age and elderly groups(P 0.05). The distributions of the onset joint among three groups revealed statistical difference(P<0.05), but the first plantar toe joint was mostly involved in each group. These results suggest that the clinical characteristics of patients with gout at different onset ages are not identical, should be treated differently. (Chin J Endocrinol Metab, 2017, 33: 581-584) Key words: Gout; Onset age; Clinical characteristics

Risk factors of gout in Jinchang cohort: a Cox regression analysis

Objective: To explore the incidence and risk factors of gout in Jinchang cohort and provide scientific evidence for the prevention and control of gout. Methods: People without gout detected by baseline survey in Jinchang cohort were selected as study subjects. All the subjects were followed up through questionnaire interview, physical examination as well as laboratory test from January 24, 2013 to November 24, 2015. Cox regression model was used to analyze the risk factors for gout in Jinchang cohort. In addition, log-linear model was used to analyze the interaction between risk factors. Results: A total of 33 153 subjects were followed up, and there were 277 newly diagnosed gout cases in the cohort. The overall incidence of gout was 0.8%. The incidence of gout in males was higher than that in the females, but the incidence of gout in males and females was similar after the age of 60 years. Cox regression analysis showed that age >40 years (at age 40 to 59 years: HR=2.982, 95%CI: 1.503-5.981; at age 60 to 91 years: HR=2.588, 95%CI: 1.107-6.049), alcohol abuse (HR=2.234, 95% CI: 1.128-4.427), obesity (HR=2.204, 95% CI: 1.216-3.997), diabetes (HR=2.725, 95% CI: 1.500-4.950) and high uric acid (HR=5.963, 95%CI: 3.577-9.943) were risk factors for gout, while weekly beans intake ≥0.25 kg (HR=0.528, 95%CI: 0.345-0.808) and regular physical exercise (HR=0.499, 95% CI: 0.286-0.869) were protective factors for gout. The analysis with log-linear model showed that there were two order effects between the risk factors. Conclusions: Age, beans intake, alcohol abuse, physical exercises, obesity, diabetes and high uric acid were important factors influencing the incidence of gout. It is important to have healthy lifestyle and dietary habits, receive regular health examination to prevent and control the incidence of gout in this cohort.

Is tea consumption associated with the serum uric acid level, hyperuricemia or the risk of gout? A systematic review and meta-analysis

BackgroundThe aim of this study was to examine the associations of tea consumption with the serum uric acid (SUA) level, hyperuricemia (HU) and the risk of gout.MethodsA comprehensive literature search up to June 2016, using PUBMED and EMBASE databases, was conducted to identify the relevant observational studies that examined the associations of tea consumption with the SUA level, HU and the risk of gout.ResultsA total of fifteen observational studies were included in this study, and nine studies were extracted for meta-analysis. For the SUA level, seven studies were included. According to the combined weighted mean difference (WMD), there was no significant difference between the highest and the lowest tea intake category in terms of the SUA level (WMD = 7.41 μmol/L, 95%CI: −2.34 to 17.15; P = 0.136). In subgroup analysis including three studies, green tea consumption was positively associated with the SUA level (WMD = 17.20 μmol/L, 95%CI: 7.00 to 27.40; P = 0.01). For the prevalence of HU, five studies were included. The overall multi-variable adjusted odds ratio (OR) for the highest versus the lowest category of tea consumption was 0.98 (95%CI: 0.77 to 1.24; P = 0.839). For the risk of gout, two prospective cohort studies showed that there was no relationship between tea consumption and the risk of gout in males and females, respectively.ConclusionThe current evidences suggest that tea consumption does not seem to be associated with the SUA level, HU and the risk of gout. However, due to the limited number of studies, green tea consumption might be positively associated with the SUA level. More well-designed prospective cohort studies are needed to elaborate these issues further.

Urinary Excretion and Renal Clearance of Allopurinol in Female Gout Patients

Drugs are excreted from the human body either unchanged or as metabolite. Gout is treated with allopurinol drug which lowers uric acid level in humans. Xanthine oxidase activity is inhibited with allopurinol which converts hypo-Xanthine and xanthine into uric acid. In case of kidney impairment monitoring of allopurinol drug metabolism was important option for optimization of allopurinol. Allopurinol level was measured in human serum and urine of gout patients after oral intake of allopurinol by using HPLC (high performance liquid chromatography). In female gout patients (n=10) allopurinol was measured in blood and urine samples at 254 nm after taking 300 mg drug. Serum uric acid level, renal function test (RFTs) and urine complete examination was checked before and after oral administration of allopurinol. Statistically results were analyzed and explained.