Gout is a painful and debilitating arthritic condition that can require lifelong treatment, either through medication or substantial lifestyle modifications. It has been estimated to affect nearly four percent of the general population in North America.
Many of us know someone who has gout. It is often referred to as “The King’s Evil,” which may refer to the fact that it is one of the few known hereditary diseases that can be passed down through royal bloodlines. Gout causes an excruciating pain in your joints, most commonly the toes and big toe, and it has been found to be on the rise due to multiple possible reasons.
Gout is a condition that can be caused by an overproduction of uric acid. This article will highlight some of the risk factors for gout so you can better protect yourself from this painful disease.
The key predictor of gout include:
Age is a predictor of gout risk
People over the age of 50 are at an increased risk for gout due to age related changes in the body. As we get older our kidneys become less efficient at filtering out uric acid, which leads to higher levels of it being produced by the liver creating a cycle that results in hyperuricemia. When this occurs it’s often referred to as primary gout or idiopathic gout.
Men are at a higher risk of developing gout
Since ancient times, gout has been a disease that disproportionately affects males. At this time, the reason for the higher risk is still unclear. Widespread obesity among men may be one contributing factor. Women are less likely to develop gout flares until after menopause.
Genetics play a large role in developing gout
Genetics play a large role in developing gout, with nearly 90% of cases being attributed to genetic factors. Gout is inherited through a recessive gene mutation called Uricase (URAT1). Specifically, a single mutated copy of the URAT1 causes the production of excess uric acid in the blood. Because of the high prevalence rate of familial gout, there may also be other genes playing a role in causing gout such as ABCG2 (a transporter protein), SLC17A1 (solute carrier family 17 member- 1) and SLC22A12 (solute carrier family).
Alcohol may serve as a trigger for gout flares
Many people believe that alcohol consumption is a trigger of gout, but it is actually more complicated than that. Alcohol consumption can lead to an increase in uric acid levels in the body, which enhances the development of gouty arthritis via increased production of xanthine crystals. However, alcohol consumption can also lead to a decrease in uric acid levels in the body, which decreases the risk for developing gout. Beer and liquor are most closely associated with increased levels of uric acid.
Body Mass Index is primary risk factor for gout
People, particularly men, with a body mass index (BMI) greater than 35 puts people at higher risk for gout. A study published in 2014 showed that BMI was associated with symptomatic gout after adjusting for all known risk factors. There may be an increased incidence of gout in patients undergoing bariatric surgery. However, there is insufficient data to support routine screening before surgery.
Dietary choices are known to trigger gout flares
Gout is a common type of arthritis that is caused by the buildup of uric acid. This can occur when people have an increased amount of purines in their diet, which are then broken down into uric acid. The more purines you eat, the more likely your levels of uric acid will increase and lead to gout. High levels of purines are found in some foods, such as liver, kidney, meat, seafood, and poultry. Consuming large amounts of carbohydrates containing fructose or sucrose increases these dietary purines. Some medications can be responsible for increasing purines: diuretics, beta blockers, and ACE inhibitors.
In conclusion, the most important predictors of gout are being over 40, male, genetic predisposition, higher alcohol consumption, obesity, and a diet high in purines.
If you want to prevent gout or manage your symptoms, please read our other articles for strategies to manage gout.