Gout is caused by the accumulation of urate crystals in the joints, which forms as a result of high levels of uric acid in the blood. The medical term for this is hyperuricemia. When hyperuricemia occurs, sharp urate crystals form in the joints and surrounding tissue, which causes pain, swelling, and inflammation. It follows that individuals with high levels of uric acid are more likely to develop gout, and anything that increases the level of uric acid in the body would then be considered a risk factor. In brief, the most common risk factors include diet and obesity, certain medications and health conditions, age and sex, recent trauma or surgery, as well as having a family history of gout.
The body produces uric acid when it breaks down purines, a type of chemical compound that occurs naturally in the body and is also found in a handful of foods and drinks. Some of the most common purine-rich foods include seafood, steak, and organ meats. As for purine-rich drinks, the two main culprits are anything sweetened with fruit sugar as well as alcoholic beverages, especially beer. While purines aren’t all bad, the problem is that diets high in purine-rich foods and drinks cause the body to produce too much uric acid. Because the body is not able to dissolve all the uric acid in the blood and pass it through the kidneys into the urine, as it normally would, any excess uric acid builds up in the blood instead.
In addition to diet, obesity is also commonly cited as a risk factor of gout. This is because individuals who are overweight or obese produce more insulin, which inhibits the ability of the kidneys to eliminate uric acid. Since elevated levels of uric acid are the primary cause of gout as well as gout flares, the more weight that an individual carries, the more likely he or she is to have recurrent gout attacks. There is also evidence to suggest that visceral fat in particular, or body fat that builds up in the abdomen, puts individuals at a higher risk of gout. This is likely due to the fact that visceral fat is linked to both insulin resistance and type 2 diabetes.
Medications linked to the development of gout are aspirin and diuretics, while health conditions associated with the disease include high cholesterol, high blood pressure, diabetes, and heart disease. Aspirin reduces the excretion of uric acid, thereby contributing to hyperuricemia, and diuretics increase urination, reducing the amount of fluid in the body and making the remaining fluid more concentrated. As for health conditions that predispose an individual to gout, most are characterized by an abnormal inflammatory response, or they affect renal function in one way or another.
Generally speaking, gout occurs more often in men than in women, due to the fact that the female body usually has lower levels of uric acid. After menopause, however, uric acid levels in women tend to approach those of men and gout becomes more likely. In terms of age, men typically experience their first episode between the ages of 30 and 50 while women tend to experience symptoms only after menopause. The risk of gout also seems to increase with age, affecting less than 3 percent of men under the age of 50 compared to upwards of 12 percent of men between the ages of 70 and 79. As for genetics, individuals who have a family history of gout are more likely to develop the disease themselves.
Resources:
- https://www.arthritis-health.com/types/gout/gout-causes-and-risk-factors
- https://www.verywellhealth.com/gout-risk-factors-189835