Historically, gout has predominantly been considered a disease in White men who overindulge in their diet. There is mounting evidence, however, that suggests gout and hyperuricemia (the precursor to gout) are more common in other demographic groups. While data for the general population are lacking for both men and women, a cross-sectional analysis published in JAMA Network Open investigated the current racial differences in gout prevalence among Black and White US adults and identify sex-specific factors related to any differences observed.
The study utilized data from the National Health and Nutrition Examination Survey (NHANES), a nationwide survey that assesses the health and nutritional status of the US population through interviews, physical examinations, and laboratory data. The authors of this study examined NHANES participants ≥18 years of age with information on gout status and serum urate levels using data collected from 2007-2016 annual NHANES cycles and compared it with previously reported NHANES. Based on existing knowledge and established literature, researchers identified and analyzed potential risk factors, including self-reported race, sex, low education level, low socioeconomic status (SES), higher body mass index (BMI), poor diet, number of weekly alcoholic beverages consumed, use of diuretics, and chronic kidney disease (CKD).
A total of 18 693 participants were included in the analysis. Of those, 3085 were Black men, 3304 were Black women, 6109 were White men, and 6195 were White women. After adjusting for age, the average gout prevalence was 7.0% in Black men, 3.5% in Black women, 5.4% in White men, and 2.0% in White women. Black race was associated with higher rates of gout overall. Concerning the racial difference among women with gout, poverty was associated with 2.4 times greater odds of gout, and current diuretic use was associated with 2.2 times greater odds. All risk factors associated with gout, excluding low-income, were prominent in the racial differences between men with gout. Alcohol consumption was a greater risk factor in White adults when compared with Black adults, regardless of sex.
The current study implies that racial and sex-specific differences in sociodemographic, lifestyle, and clinical factors play a greater role in the diagnosis of gout in US adults, specifically in regard to poorer access to healthcare among Black patients. The authors of the study suggest that culturally informed interventions focusing on the reported risk factors could reduce the current racial and sex-specific disparities in gout patients.