Epidemiology, risk factors, and lifestyle modifications for gout.

UAB Center for Education and Research (CERTs) on Therapeutics of Musculoskeletal Disorders, Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Arthritis research & therapy (Impact Factor: 4.12). 02/2006; 8 Suppl 1:S2. DOI: 10.1186/ar1907
Source: PubMed

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.

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    ABSTRACT: Diet plays an important role in the pathogenesis of abnormal serum uric acid (UA) levels and associated complications. Diet modification has been universally adopted as an important and early intervention approach to reduce or increase UA production and/or enhance or inhibit UA excretion. This article reviews the literature on the effects of diets and dietary factors on serum UA levels. The most recently published studies make dietary recommendations aiming to modulate UA levels, including the consumption of low-fat dairy products, whole grains, vegetables, fruits, nuts, legumes, vitamin C, and coffee as well as the moderation of sugary foods, meats and meat products, seafood, and sugar-sweetened beverages. Individuals with gout should avoid consuming organ meats, sweet breads, high fructose corn syrup, sweetened beverages, and alcohol and should avoid alcohol altogether during periods of frequent gout attack. Serving sizes of meat and meat products, seafood, table sugars, sweetened beverages, table salt, and alcohol should be limited, whereas low-fat or non-fat dairy products and vegetables should be encouraged. Dietary intervention remains the only non-pharmacological approach for the long-term prevention, control, and management of abnormal serum UA levels and associated complications in humans.
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    ABSTRACT: AimOriginal studies have employed various genetic models in association analysis between ABCG2 Q141K (rs2231142) with gout risk and different or conflicting results, especially regarding the role of gender in this association. In addition, it is not clear whether the association varies by ethnicity.Method Articles published before September 1, 2013 were extracted and registered into databases for the systematic review of this polymorphism. The quality of each study was scored based on predefined criteria. The genetic model was identified through stratification analysis, then a meta-analysis including all publically available data was preformed to test the association between rs2231142 and gout risk. Potential sources of heterogeneity were sought out via stratification analysis and meta-regression analysis.ResultsNine case–control studies involving 17 942 individuals were eligible for the meta-analysis of rs2231142. Codominant model was the most appropriate genetic model to interpret the susceptibility cause. It showed that the rs2231142 T allele obviously increased gout risk, and TT was much stronger than GT (TT vs. GG: OR, 4.10; 95% CI, 2.90–5.80; GT vs. GG: OR, 1.71, 95% CI, 1.39–2.10). In addition, gender and ethnicity were found to affect the association between the susceptibility of gout and rs2231142.ConclusionABCG2 rs2231142 is an important genetic factor in increasing gout risk, and the difference in genetic association has been found between male and female populations. In addition, the degree of association has been found to vary with ethnicity.
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