Genetic factors: Uric acid and gout both appear to have a genetic component, with uric acid levels estimated to be about 63% heritable.[1] A number of genes have been identified that influence gout risk and/or uric acid levels (SLC2A9, SLC22A12, and ABCG2, among others), most of which appear to primarily affect uric acid excretion by the kidneys.[2]
Body weight: Having overweight or obesity is associated with a much higher risk of gout,[3] with one meta-analysis reporting people with obesity were 2.24 times more likely to develop gout.[4]
Alcohol: Alcohol consumption can increase uric acid levels[5] and is associated with a higher risk of gout.[6] This effect may vary by the source of alcohol, as some research has observed an association between uric acid levels and intake of beer and liquor but not with wine.[7][8]
Diet: One meta-analysis of observational studies reported that risk of gout was associated with an increased consumption of red meat, seafood, alcohol, and fructose.[9] These foods were likewise associated with a higher risk of hyperuricemia. In general, this appears somewhat consistent with clinical research.
Medications: A number of drugs appear to increase uric acid and the risk of gout, including certain diuretics, immunosuppressant drugs, high doses of vitamin B3 (nicotinic acid), and low doses of aspirin.[10]
Kidney disease: Kidney disease is strongly associated with elevated uric acid and gout, although the nature of this relationship is debated. Specifically, reductions in kidney function might increase uric acid levels, or increased uric acid might cause reduced kidney function, or possibly a mix of both.[11]
Hypertension: Hypertension is associated with higher uric acid levels, possibly as a result of effects of high blood pressure on kidney function. However, as with kidney disease, this association could be backwards, with some research indicating uric acid may increase blood pressure.[12][13]
References
- ^Qiong Yang, Chao-Yu Guo, L Adrienne Cupples, Daniel Levy, Peter W F Wilson, Caroline S FoxGenome-wide search for genes affecting serum uric acid levels: the Framingham Heart StudyMetabolism.(2005 Nov)
- ^Nicola Dalbeth, Lisa K Stamp, Tony R MerrimanThe genetics of gout: towards personalised medicine?BMC Med.(2017 May 31)
- ^Dagfinn Aune, Teresa Norat, Lars J VattenBody mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studiesEur J Nutr.(2014 Dec)
- ^Peter L Evans, James A Prior, John Belcher, Christian D Mallen, Charles A Hay, Edward RoddyObesity, hypertension and diuretic use as risk factors for incident gout: a systematic review and meta-analysis of cohort studiesArthritis Res Ther.(2018 Jul 5)
- ^J Faller, I H FoxEthanol-induced hyperuricemia: evidence for increased urate production by activation of adenine nucleotide turnoverN Engl J Med.(1982 Dec 23)
- ^Meiyun Wang, Xiubo Jiang, Wenlong Wu, Dongfeng ZhangA meta-analysis of alcohol consumption and the risk of goutClin Rheumatol.(2013 Nov)
- ^Angelo L Gaffo, Jeffrey M Roseman, David R Jacobs Jr, Cora E Lewis, James M Shikany, Ted R Mikuls, Pauline E Jolly, Kenneth G SaagSerum urate and its relationship with alcoholic beverage intake in men and women: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) cohortAnn Rheum Dis.(2010 Nov)
- ^Hyon K Choi, Gary CurhanBeer, liquor, and wine consumption and serum uric acid level: the Third National Health and Nutrition Examination SurveyArthritis Rheum.(2004 Dec 15)
- ^Rongrong Li, Kang Yu, Chunwei LiDietary factors and risk of gout and hyperuricemia: a meta-analysis and systematic reviewAsia Pac J Clin Nutr.(2018)
- ^C Ben Salem, Raoudha Slim, Neila Fathallah, Houssem HmoudaDrug-induced hyperuricaemia and goutRheumatology (Oxford).(2017 May 1)
- ^Richard J Johnson, Takahiko Nakagawa, Diana Jalal, Laura Gabriela Sánchez-Lozada, Duk-Hee Kang, Eberhard RitzUric acid and chronic kidney disease: which is chasing which?Nephrol Dial Transplant.(2013 Sep)
- ^Richard J Johnson, Hyon K Choi, Anthony E Yeo, Peter E LipskyPegloticase Treatment Significantly Decreases Blood Pressure in Patients With Chronic GoutHypertension.(2019 Jul)
- ^Sanaz Sedaghat, Raha Pazoki, Andre G Uitterlinden, Albert Hofman, Bruno H Ch Stricker, M Arfan Ikram, Oscar H Franco, Abbas DehghanAssociation of uric acid genetic risk score with blood pressure: the Rotterdam studyHypertension.(2014 Nov)