what causes gout?

Gout is a form of inflammatory arthritis caused by the buildup of uric acid in the body, which forms urate crystals in and around the joints. Here are the key factors that contribute to the development of gout:

Uric Acid Buildup

Gout occurs when there is too much uric acid in the blood. This can happen for two main reasons:

• Overproduction of Uric Acid: About 10% of gout cases are due to the body producing too much uric acid, often because of genetic defects in the purine breakdown pathway or increased cell turnover (e.g., during chemotherapy)35.
• Inadequate Excretion of Uric Acid: The most common cause (about 90% of cases) is the kidneys' inability to excrete enough uric acid. This can be due to genetic defects in organic anion transporters in the kidneys, poor kidney function, or the use of certain medications like diuretics, low-dose aspirin, or alcohol34.

Dietary Factors

Consuming foods and beverages high in purines can increase uric acid levels. These include:

• Alcoholic drinks and sugary drinks high in fructose
• Certain meats like game meats, kidney, brains, and liver
• Dried beans and dried peas
• Seafood such as anchovies, herring, scallops, sardines, and mackerel235.

Lifestyle and Environmental Factors

• Alcohol Consumption: Drinking alcohol can trigger gout attacks and increase uric acid levels245.
• Dehydration: Not drinking enough water can lead to concentrated urine and higher uric acid levels4.
• Injuries and Illnesses: Injuries to joints or illnesses that cause high temperatures can trigger gout attacks4.

Health Conditions and Medications

Certain health conditions and medications can increase the risk of developing gout:

• Obesity and Metabolic Syndrome: Conditions like high blood pressure, high blood sugar, abnormal cholesterol levels, and excess body fat around the waist
• Chronic Kidney Disease: Poor kidney function can impair uric acid excretion
• High Blood Pressure and High Cholesterol: These conditions are often linked with gout
• Diabetes and Osteoarthritis: These conditions can also increase the risk
• Medications: Diuretics, ACE inhibitors, and other medications can affect uric acid excretion245.

Genetic and Demographic Factors

• Family History: Gout can run in families45.
• Gender and Age: Gout is more common in men, especially between the ages of 40 and 60. Women are less likely to develop gout until after menopause due to the protective effect of estrogen on uric acid excretion345.

Understanding these factors is crucial for managing and preventing gout attacks.