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Abstract
Gout is an inflammatory arthritis characterized by recurrent attacks of inflammation caused by precipitation of monosodium urate crystals (MSU) in the joint and is associated with impaired quality of life. The incidence and prevalence of gout is increasing world wide due to the increasing size of the elderly population, kidney disease, diuretic use, dietary changes, and obesity. Furthermore, emerging evidence suggests that gout is strongly associated with metabolic syndrome and may lead to myocardial in-farction, type 2 diabetes mellitus, and premature death. Urate nephropathy is also increasing. Thus, the overall disease and the economic burden of gout is substantial and increasing sharply. Although traditional urate lowering agents including allopurinol, probenecid, and benzbromar-one have been available for many years, questions still re-main about the optimal dosing regimen. Many patients re-main undertreated for this potentially curable disorder. Fortunately, more scientific data and evidence for proper management of gout are available. Renewed interest in gout has led to advances in dietary advice and development of new therapeutic options. The importance of risk factors for gout should be emphasized and patients with gout and hyperuricemia should be educated so that they can achieve a good quality of life and longevity. In this review, the comorbidity, mortality, and economic burdens of gout will be presented. In addition, the importance of proper management and patient education will be stressed.
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Figure 1.
Patients with gout typically harbor multiple comorbidities. The prevalence of having 0 to 7 associated comorbidities was determined among patients with gout in each of the 3 defined cohorts.
Table 1.
Unadjusted and age-adjusted comparison of the prevalence of gout and hyperuricemia among US adults between NHANES-III (1988∼1994) and NHANES 2007∼2008∗
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