Gout is in Your Genetics

    A February 13th article from Science Alert claims gout has less to do with lifestyle choices and more with genetics. The Mayo Clinic describes gout as a painful and complex form of arthritis that arises from high levels of uric acid in the bloodstream. Often, the symptoms arise overnight and suddenly. Intense joint pain, inflammation and redness, and limited range of motion are all symptoms of gout, and often something as light as a bedsheet on the affected area is unbearable. The Mayo Clinic lists one of the main causes of gout as diet especially increased intake of purine-rich seafoods, alcoholic beverages, and drinks sweetened with fruit sugar. However, the Science Alert article argues against the hypothesis that lifestyle choices are the main cause of gout. Instead, they present research that shows 120,295 people with gout had the same variations at 377 specific DNA regions which are now thought to have a large impact on developing gout. The 377 specific DNA regions identified in the new study include 149 regions that had not previously been linked to gout. The researchers maintain that there are still undiscovered genetic links to the disease that have yet to be discovered. The connection of genes to gout formation allows new research to be done regarding how gout can be treated with genetics as the basis for treatment. 

    Personally, I can’t wait to tell my dad about this research because he stopped eating shrimp about a decade ago after he developed gout “from the shrimp.” However, this new study demonstrates that he might have had an underlying condition that made him more susceptible to gout and his consumption of shrimp might not have been the reason for his gout flareup. I think this new explanation will hopefully allow more people to get treatment for their chronic gout. The article mentions that some people do not seek out medical help when they experience gout because they are ashamed of their lifestyle choices, but having a genetic explanation for the formation of gout would be out of the patient’s control, so they may be more willing to seek out a doctor’s help. As I mentioned earlier, my dad had a few cases of gout, so knowing that there is a genetic link, now I am curious if I have some of the alleles that increase the risk for gout development. 

Links

https://www.sciencealert.com/huge-study-shows-where-gout-comes-from-its-not-what-we-thought

https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897

Genetics Indicate Higher Risk Factor for Gout than the Previously Thought Diet

In this research study conducted by Major, Topless, Daleth and Merriman, diet and genetics were evaluated as risk factors for gout and their association with serum rate levels. Gout is a common disease that can lead to intense pain in joints, mostly seen on the outside of the big toe. Gout is caused by an accumulation of urate crystals in the joints, which occurs when high levels of uric acid develops in the blood. Many believe this accumulation is primarily due to diet, where certain food and beverages stimulate an increase in uric acid. However, in the study performed by Major et al., they found that genetics had a higher rate of variance in serum urate levels than certain trigger foods did, 23.9% compared to <1%.

The researchers obtained those percentages by analyzing the diet and genome of close to 17,000 individuals (equal parts male and female), while measuring their serum rate levels along the way. Participants were required to be eighteen years of age, and have no history of gout.

With these results, the researchers hope to dispel the common misconception that gout is caused primarily by diet, which the they believe is a primary reason why patients are uncomfortable talking with their physicians about it. With this hanging stigma that gout is the fault of the patient, many affected people don't seek treatment, which is a shame due to the highly painful nature of the condition. Although these findings hold contrary to popular belief, professionals still advise the consumption of a healthy diet to further decrease risks.

Personally, I am not affected by gout and neither my family, however, reading about the symptoms of the condition I can get a sense of how severe gout can be. Knowing that there is a stigma about gout patients, and how this discourages seeking of treatment is truly unfortunate. Although gout can be really painful, and that treatment is manageable with serum rate lowering drugs, I find it disheartening that affected people are willing to risk going untreated so they won't be judged by their physician. I hope in light of this study, patients with gout can be seen in a new perspective and that patients are willing to seek treatment to alleviate this condition.

Related Links
Article
(on gout drug)