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Risk factors for gout and prevention: a systematic review of the literature

Singh, Jasvinder Aa,b,c,d; Reddy, Supriya Gb,e; Kundukulam, Josephb

Current Opinion in Rheumatology: March 2011 - Volume 23 - Issue 2 - p 192–202
doi: 10.1097/BOR.0b013e3283438e13
Epidemiology and health-related services: Edited by Daniel Solomon and Karen Costenbader

Purpose of review Our objective was to perform a systematic review of risk factors and prevention of gout. We searched Medline for fully published reports in English using keywords including but not limited to ‘gout’, ‘epidemiology’, ‘primary prevention’, ‘secondary prevention’, ‘risk factors’. Data from relevant articles meeting inclusion criteria were extracted using standardized forms.

Recent findings Of the 751 titles and abstracts, 53 studies met the criteria and were included in the review. Several risk factors were studied. Alcohol consumption increased the risk of incident gout, especially beer and hard liquor. Several dietary factors increased the risk of incident gout, including meat intake, seafood intake, sugar sweetened soft drinks, and consumption of foods high in fructose. Diary intake, folate intake, and coffee consumption were each associated with a lower risk of incident gout and in some cases a lower rate of gout flares. Thiazide and loop diuretics were associated with higher risk of incident gout and higher rate of gout flares. Hypertension, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, diabetes, obesity, and early menopause were each associated with a higher risk of incident gout and/or gout flares.

Summary Several dietary risk factors for incident gout and gout flares are modifiable. Prevention and optimal management of comorbidities are likely to decreased risk of gout. Research in preventive strategies for the treatment of gout is needed.

aMedicine Service and Center for Surgical Medical Acute care Research and Transitions (C-SMART), Birmingham VA Medical Center, Birmingham, Alabama, USA

bDepartment of Medicine, USA

cDivision of Epidemiology at School of Public Health, University of Alabama, Birmingham, Alabama, USA

dDepartment of Orthopedic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA

eDepartment of Health Science, University of Alabama, Tuscaloosa, Alabama, USA

Correspondence to Jasvinder A. Singh, MBBS, MPH, University of Alabama, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294, USA Tel: +1 205 996 5885; fax: +1 205 996 9685; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.