New evidence that gout runs in the family

It’s historically known as “the king of diseases and the disease of kings” and was long thought to be caused by an overindulgent lifestyle, but now scientists at The University of Nottingham have confirmed that gout strongly runs in families.

Researchers in the Division of Rheumatology, Orthopaedics and Dermatology studied the whole population of Taiwan (23 million) where gout is most prevalent in the world, and published their findings in the Annals of the Rheumatic Diseases.

By examining 4.2 million identifiable families, the scientists found compelling evidence that gout clusters in families, with increased risks for people with first and second degree relatives suffering from the disease.

Gout is a kind of inflammatory arthritis, with sudden onset of acute pain, redness and swelling in peripheral joints, most commonly the joint in the big toe. It is caused by the deposition of monosodium urate crystals, which is related to high uric acid in the blood. The resulting acute arthritis and lumps around the joint cause disability due to pain and loss of joint function.

Increasing evidence suggests that gout is associated with heart attack, stroke and kidney failure.

“Our results confirm the clinical belief that gout strongly clusters within families,” says study author, Dr Chang Fu Kuo. “In Taiwan the risk of an individual with any first-degree relative suffering from gout is approximately twice that of the normal population.

“The risk increases with the number of the first-degree relatives affected.  Having a twin brother with gout carries an 8-fold risk, whereas having a parent or offspring with gout has a 2-fold risk. The study also demonstrates that in addition to the genetic risk, shared environment factors play a substantial role in the aetiology of gout. The influences of environmental and genetic factors on the risk of gout are different in men and women. Genetic factors contribute one-third in men and one-fifth in women.”

Large-scale genetic profiling is now needed to find susceptibility genes.