![]() ![]() The natural course of classic gout passes through three stages: asymptomatic hyperuricemia, acute intermittent gout symptoms, and chronic persistent gout symptoms. Lee Goldman MD, in Goldman-Cecil Medicine, 2020 Classic Gout Further, gout prevalence seems to be higher in particular populations such as New-Zealand Maori and Hmong Chinese. But this study did not adjust for differences in uric acid levels and renal function disturbances. In another study comparing the risk of black and white people, the higher risk of gout in black men was suggested to be related to hypertension. In the ARIC study, higher uric acid levels may partially explain the higher risk of gout, especially in men. In a recent study from Atherosclerosis Risk in Communities (ARIC), blacks had a 1.5 times higher risk of gout, even after adjustment for well-known confounders. In the NHANES 2007–2008 study, the prevalence of gout was reportedly higher in black people (5.0%, 95% CI 3.3–6.6%) compared to white people (4.0%, 95% CI 3.3–4.8%). The prevalence of gout is also dependent on ethnicity. In men, gout prevalence rises from the age of 35 onward. In the postmenopausal period, the prevalence of gout in women tends to rise, but never attains the same levels as in men. This difference between men and women has been attributed, at least partially, to the uricosuric effects of estrogen. The NHANES 2007–2008 estimated the prevalence of gout in men at 5.9% and in women at 2.0%. For the past years, evidence has shown that there is an association between gout and cardiovascular diseases and that they share possible common pathophysiological pathways.Īs in cardiovascular diseases, men are more frequently affected by gout than women. Cardiovascular diseases are the main cause of death worldwide, with coronary heart diseases being the most prevalent. Fructose, abundantly present in sugar-sweetened beverages, has been incriminated as a possible explanation of this rise in the prevalence of gout, obesity, and metabolic syndrome : Fructose may cause a rise in serum uric acid by increasing the degradation of ATP to AMP, which is further metabolized to uric acid. This rise in gout prevalence coincides with a rise in the prevalence of obesity and metabolic syndrome. Several reports suggest the prevalence of gout is increasing while others do not. The most recent data from the National Health and Nutrition Examination Survey (NHANES) 2007–2008 estimate the prevalence of gout to be 3.9% in the United States. Gout is among the most common forms of inflammatory arthritis. Landewé, in The Heart in Rheumatic, Autoimmune and Inflammatory Diseases, 2017 1.1 Epidemiology of Gout
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