Genetics more likely to lead to gout

A STUDY revealing a relatively weak link between the consumption of rich food and urate levels in the blood is the starting point for more work into why some people are more likely to develop gout, ‘‘the disease of kings’’.

A University of Otago study led by postdoctoral research fellow Tanya Major has found that in healthy people, genetics were significantly more likely than unhealthy food to lead to higher urate levels.

‘‘It came as no surprise that genetic factors have a larger influence on serum urate than dietary factors, but what did surprise us was the magnitude of this difference, an almost 100fold increase,’’ Dr Major said.

‘‘This is contrary to popular medi cal opinion and the common perceptions of the general public.’’

The results of the study were published in The BMJ yesterday.

The study involved the effect of 63 different food items, across a range of food groups.

She hoped the findings would encourage health practitioners to focus on other ways to manage urate levels, such as allopurinol [a medication used to decrease uric acid levels] use, rather than dietary modifications.

High urate levels are necessary for gout — people whose urate levels are above a certain amount develop urate crystals in their joints.

In some people the formulation of crystals was as far as it went, but in others their body recognised the crystals should not be there, and the person’s immune system attacked them.

‘‘That is when a gout flare happens,’’ Dr Major said.

‘‘We don’t know yet why some people with crystals get gout and some people with them do not, but we are currently working on the largest genetic study of gout ever done.’’

Dr Major found in the healthy population studied for her latest piece of research, no single food studied explained more than 1% of variation in serum urate levels.

She and the other researchers, from Otago and the University of Auckland, hoped the result for urate in people who actually had gout would turn out the same.

‘‘But if they don’t we wouldn’t expect the influence of diet to be close to the influence of genetics.’’