Hyperuricemia is the underlying cause of gout. This can occur for a number of reasons, including diet, genetic predisposition, or underexcretion of urate, the salts of uric acid. Renal underexcretion of uric acid is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%. About 10% of people with hyperuricemia develop gout at some point in their lifetimes. The risk, however, varies depending on the degree of hyperuricemia. When levels are between 415 and 530 μmol/l (7 and 8.9 mg/dl), the risk is 0.5% per year, while in those with a level greater than 535 μmol/l (9 mg/dL), the risk is 4.5% per year.Genetics
The occurrence of gout is partly genetic, contributing to about 60% of variability in uric acid level. Three genes called SLC2A9, SLC22A12 and ABCG2 have been found to commonly be associated with gout, and variations in them can approximately double the risk. Loss of function mutations in SLC2A9 and SLC22A12 cause hereditary hypouricaemia by reducing urate absorption and unopposed urate secretion. A few rare genetic disorders, including familial juvenile hyperuricemic nephropathy, medullary cystic kidney disease, phosphoribosylpyrophosphate synthetase superactivity, and hypoxanthine-guanine phosphoribosyltransferase deficiency as seen in Lesch-Nyhan syndrome, are complicated by gout.
Who Gets Gout?
Gout is caused by a buildup of uric acid in your blood. As your uric acid level rises, so does the potential for gout and gout flares. You should also be aware of certain characteristics that can affect your likelihood of experiencing gout:
- Men, especially between the ages of 40 and 50, are more likely to develop gout than women.
- Most women experience gout after menopause.
- There may be a genetic link: many people with gout have a family history of the disease.
- Gout rarely affects children or young adults.
- People with certain conditions are at a higher risk for gout: These conditions include diabetes, high cholesterol, high blood pressure, and/or kidney problems.
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