Female gout: Clinical and laboratory features

Rheumatology Division, Universidade Federal de São Paulo, São Paulo-SP, Brazil.
The Journal of Rheumatology (Impact Factor: 3.19). 12/2005; 32(11):2186-8.
Source: PubMed


To evaluate and compare clinical and laboratory features of gout in men and women.
Twenty-seven women and 31 men with gout underwent clinical and laboratory evaluation and review of medical records.
Disease onset in women was a mean of 7 years later than in men. There were no differences between women and men regarding systemic hypertension, diabetes mellitus, hyperlipidemia, chronic renal failure, renal stones, ischemic heart disease, or heavy alcohol consumption. Tophaceous gout was similar in both groups, although female gender seemed to be protective against risk of developing tophi (odds ratio: 0.449; 95% confidence interval: 0.151-1.330). Podagra was more common in men, and women showed a higher frequency of upper limb joint involvement. Most patients had low urate excretion rates. Achieving disease control was similar in women and men. Of the 8 women who were premenopausal at disease onset, 7 had secondary causes for gout; 5 of the 8 had high serum urate despite treatment.
Gout in women had a later onset and higher frequency of upper limb joint involvement in comparison to men. Those with premenopausal onset tended to be refractory to standard therapy.

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    • "Different from these studies, we focused on the elderly and the women have all hit menopause. There is evidence showing estrogens in women may promote more efficient renal clearance of urate and explaining a substantial portion in the SUA level [20, 22]. Gouty arthritis and cardiovascular complications are rarely observed in premenopausal women; however, the incidences of hyperuricemia and MetS increase dramatically after menopause [20]. "
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    ABSTRACT: Objective . This study aimed to evaluate the association between serum uric acid (SUA) levels within a normal to high range and the risk of metabolic syndrome (MetS) among community elderly and explore the sex difference. Design and Methods . A cross-sectional study was conducted in a representative urban area of Beijing between 2009 and 2010. A two-stage stratified clustering sampling method was used and 2102 elderly participants were included. Results . The prevalence of hyperuricemia and MetS was 16.7% and 59.1%, respectively. There was a strong association between hyperuricemia and four components of MetS in women and three components in men. Multiple logistic regression analysis showed ORs of hyperuricemia for MetS were 1.67 (95% CI: 1.11–2.50) in men and 2.73 (95% CI: 1.81–4.11) in women. Even in the normal range, the ORs for MetS increased gradually according to SUA levels. MetS component number also showed an increasing trend across SUA quartile in both sexes ( P for trend
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    • "These results were also inconsistent, 25% of the women vs 19% of the men [19], 26% of the women vs 57% of the men [20], 25% of the women vs 16% of the men [21], and 0% of the women vs 11% of the men [23]. Dyslipemia was more common in women (42% vs 38%) [18–21] and Deesomochok et al. did not find a sex difference in cerebral vascular accident in gout patients [23]. In this study, a significantly higher prevalence of hematologic malignancies was found in female gout patients, 22% of the women compared to 3% of the men [23]. "
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    ABSTRACT: Clinically, gout is generally considered as a preferential male disease. However, it definitely does not occur exclusively in males. Our aim was to assess differences in the clinical features of gout arthritis between female and male patients. Five electronic databases were searched to identify relevant original studies published between 1977 and 2007. The included studies had to focus on adult patients with primary gout arthritis and on sex differences in clinical features. Two reviewers independently assessed eligibility and quality of the studies. Out of 355 articles, 14 were selected. Nine fulfilled the quality and score criteria. We identified the following sex differences in the clinical features of gout in women compared to men: the onset of gout occurs at a higher age, more comorbidity with hypertension or renal insufficiency, more often use of diuretics, less likely to drink alcohol, less often podagra but more often involvement of other joints, less frequent recurrent attacks. We found interesting sex differences regarding the clinical features of patients with gout arthritis. To diagnose gout in women, knowledge of these differences is essential, and more research is needed to understand and explain the differences , especially in the general population.
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    • "Given the coinciding time periods, investigators inferred that this observation may be due to hormonal changes accompanying the menopause. Furthermore, previous case series found that the vast majority of female gout cases were diagnosed after menopause [15,18,19,21]. We found that serum uric acid levels among women increased from age 50 to 59 onwards and the increase extended up to the highest age category of 70 years of age and older. "
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