Update on factors predisposing to gout

Recent genetic, epidemiological and clinical studies have confi rmed multiple factors predisposing to gout. Polymorphisms have been identifi ed in genes encoding renal urate transporters and infl ammatory cytokines. Epidemiological studies have established alcohol, dietary factors, hypertension, obesity, insulin resistance, diuretic therapy and chronic renal disease as independent risk factors predisposing to gout. In addition to the well-recognized infl uence of dietary purines, causative roles have been suggested for fructose and sugar-sweetened soft drinks, and protective roles for dairy products, coffee and vitamin C. Gout makes an independent contribution to the development of diabetes and cardiovascular disease. Osteoarthritis appears to predispose to local crystal deposition, but is not a risk factor for the development of gout per se.