Women and Men With Gout Share Certain Risk Factors
Women and Men With Gout Share Certain Risk Factors
Whether male or female, people suffering with gout do share certain risk factors, according to research presented at the November 2005 American College of Rheumatology's Annual Scientific Meeting. The National Institutes of Health has reported that:
Gout occurs in approximately 840 out of every 100,000 people.
Gout is rare in children and young adults.
Men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause.
Why The Study?
Gout has been described as occurring predominately in men. However, increasing incidences of gout among women and the possibility that the historically male-focused medical studies may have swayed some of these statistics motivated researchers to study the characteristics of gout in women.
What Is Gout?
Gout is one of the most painful rheumatic diseases and accounts for approximately 5 percent of all cases of arthritis. The term arthritis refers to more than 100 different types of rheumatic diseases that affect the joints, muscles, and bones, as well as other tissues and structures.
Gout results from deposits of needle-like crystals of uric acid in connective tissue, in the joint space between two bones, or in both. These deposits lead to inflammatory arthritis, which causes swelling, redness, heat, pain, and stiffness in the joints.
Hyperuricemia
Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods.
Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine where it is eliminated. If the body increases production of uric acid or if the kidneys do not eliminate enough uric acid from the body, uric acid levels build up in the blood (a condition called hyperuricemia).
Risk Factors
A number of risk factors are related to the development of hyperuricemia and gout:
Genetics (up to 18 percent of people with gout have a family history of the disease)
Gender (gout is more common in men than in women)
Age (gout is more common in adults than in children)
Weight (being overweight leads to excess uric acid production)
Excessive alcohol intake (drinking too much alcohol can lead to hyperuricemia)
Enzyme defects (can interfere with the way the body breaks down purines causes gout)
Exposure to lead (lead can also cause gout)
Diet
A high-purine diet (i.e. foods rich in purines can cause or aggravate gout)
Certain Medicines
Some people who take certain medicines or have certain health conditions are at risk for having high levels of uric acid in their body fluids. Some drugs can lead to hyperuricemia because they reduce the body's ability to remove uric acid. These drugs include:
Diuretics (drugs that increase the rate of urine excretion)
Salicylates (anti-inflammatory medicines made from salicylic acid such as aspirin)
Niacin (this vitamin also called nicotinic acid)
Cyclosporine (an immunosuppressant)
Levodopa (used to treat Parkinson's Disease)
About The Study
Over a 24-year period, researchers studied results based on a prospective cohort of women to determine if there really was a difference in risk factors and associated incidences of gout across the two sexes. Information was collected from a large female population regarding:
Weight
Body mass index
Medical conditions
Medical therapies (including the use of diuretics)
Dietary and alcohol intake
Lifestyle
New cases of gout documented since 1980 (a total of 444) were then assessed based on exposure to known potential gout risk factors such as:
Age
Weight levels
Dietary intake
Relevant medical history
Use of certain medications
Study Results
Results showed there is little difference in the way these risk factors affect the disease in men and women. Higher risks of gout proved to be associated with an increased:
Body mass index
Weight
Waist-to-hip ratio
Compared to those in the lowest category, women with the highest category of body mass index had a seven-fold increased risk of gout.
Other Study Findings
Hypertension and an increased use of diuretics also had a strong independent effect on the risk of gout.
Increasing dairy intake was also associated with a decreased risk of gout, replicating occurrence traits in men.
Comprehensive and persistent efforts to modify these risk factors in both sexes could help to substantially reduce the incidence of gout and associated morbidities.
Gout prevention and treatment strategies for these factors should be advisable for both sexes.
Growing epidemics of obesity and the increasing prevalence of hypertension and diuretic use also present a substantial challenge in the prevention and management of gout.
Conclusions
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