Gout more prevalent among Black adults, men
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In the United States, gout is more prevalent among Black adults than white adults, as well as among men compared with women, according to data published in JAMA Network Open.
The researchers added that this disparity between Black and white adults may be explained by socioclinical factors such as poverty and diet.
“Previous studies have suggested that compared with white U.S. residents, Black U.S. residents are at increased risk for gout and lower health-related quality of life,” Natalie McCormick, PhD, of the clinical epidemiology program in the division of rheumatology, allergy and immunology at Massachusetts General Hospital, in Boston, and colleagues wrote.
“However, national-level general population data on sex-specific racial differences in the burden of gout are lacking,” they added. “Importantly, potential racial differences may be largely attributable to differences in nongenetic social determinants of health rather than ancestry-specific differences in genes regulating urate handling.”
To investigate the sex-specific factors behind disparities of gout prevalence in Black and white adults in the United States, McCormick and colleagues conducted a cross-sectional analysis of data from the National Health and Nutrition Examination Survey. According to the researchers, this survey which uses a “complex, multistage probability design” to ensure a properly representative sample is produced. To be included in the analysis, patients were required to be aged 18 years or older and have data regarding gout and serum urate levels available, collected during the 2007-2008 through 2015-2016 cycles.
Survey respondents participated in face-to-face interviews, in which they reported their age, sex, race and ethnicity, level of educational achievement, household size and income, recent diet intake, medical history and prescription usage. Although race and ethnicity categories included Hispanic, non-Hispanic Asian, non-Hispanic white and non-Hispanic Black, the analysis was limited to patients identifying as white or Black.
During interviews, participants were asked if they were ever told they had gout, while serum urate levels were measured via blood tests. Potential gout risk factors included educational achievement levels, poverty, BMI, amount of alcohol consumed per week, poor diet quality, recent diuretic use and chronic kidney disease (CKD).
In total, the analysis included 18,693 participants, including 3,304 Black women, 6,195 white women, 3,085 Black men and 6,109 white men.
According to the researchers, the age-standardized prevalence of gout was 3.5% (95% CI, 2.7% to 4.3%) in Black women, compared with 2% (95% CI, 1.5% to 2.5%) in white women. Among Black men, the age-standardized rate of gout was 7% (95% CI, 6.2% to 7.9%) and in white men it was 5.4% (95% CI, 4.7% to 6.2%).
“In this nationally representative race- and sex-specific cross-sectional study of U.S. adults, gout was more prevalent in adults self-reporting Black race during a recent 10-year period compared with their white counterparts,” McCormick and colleagues wrote.
“Moreover, these differences may be explained by racial differences in key socioclinical factors, including excess BMI, poverty and poor diet as well as CKD in women and by CKD, poor diet and diuretic use in men,” they added. “Culturally informed interventions designed to address adiposity and kidney disease and improve diet quality while recognizing the role of poverty in gout among women could help reduce these disparities.”
References:
Maynard JW, et al. Am J Epidemiol. 2014;doi:10.1093/aje/kwt299 10.1093/aje/kwt299
Hochberg MC, et al. Arthritis Rheum. 1995;doi:10.1002/art.1780380508
Singh JA, et al. Rheumatology. 2017;doi:10.1093/rheumatology/kew356
Thompson MD, et al. J Rheumatol. 2022;doi:10.3899/jrheum.210394
Tin A, et al. Nat Genet. 2019;doi: 10.1038/s41588-019-0504-x
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