Older Women who Drink May Triple Risk of Gout

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Boston University School of Medicine researchers have discovered that women with serum uric acid levels over 5 mg/dl had a significantly lower risk of developing gout than men.

This study, which is the first the first to examine the relationship between uric acid levels and gout risk in women, evaluated purported risk factors for gout and found that increasing age, obesity, hypertension, alcohol use, and diuretic use to be among leading contributors for women.

The team, which was led by Hyon Choi, M.D., D.Ph., looked at data from the Framingham Heart Study for 2,476 women and 1,951 men who had a complete follow-up history and did not have any symptoms of gout at baseline. The age at baseline was 47 years for women and 46 years for men.

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Researchers evaluated serum uric acid levels and risk factors including age, body mass index (BMI), alcohol consumption, hypertension, medication use (diuretics, hormone replacement therapy), blood glucose and cholesterol levels, and menopause status.

"We identified 104 gout cases in women and 200 in men over the 28-year median follow-up period," said Dr. Choi. "The gout incidence per 1,000 person-years was 1.4 in women and 4.0 in men."

Results further found that among the risk factors for gout, increasing age, obesity, alcohol consumption, diuretic use, and hypertension were independently associated with higher risk of gout incidence in women.

Gout occurs when elevated blood levels of uric acid form crystals in the joints and surrounding tissue, leading to excruciatingly painful inflammation and swelling. The big toe, knee, and ankle joints are the most common sites for gout, and attacks frequently start during the night. The painful swelling typically goes away in a few days, but more than half of people who have one attack will have others.

"Our study found that higher levels of uric acid in the blood increase the risk gout risk for women in a graded manner," concluded Dr. Choi. "Confirming our results using specific case definitions (observation of urate crystal in joint fluid) would provide to be a valuable contribution to understanding gout incidence in both sexes."

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