Gout and Hyperuricaemia in Rural and Urban Populations

Abstract

Estimates of the prevalence of gout in different countries vary widely, but previously reported studies have related to selected groups, such as patients attending a hospital clinic, and no reliable information is available of the prevalence of the disease in the general population. Many wellauthenticated reports have shown that the incidence of asymptomatic hyperuricaemia is in the region of 25 per cent. in the blood relatives of patients with gout (Talbott, 1940; Smyth, 1957; Stecher, Hersh, and Solomon, 1949 57 sera covering the range of values found in these surveys were analysed in duplicate by both the enzymatic and colorimetric methods. A comparison of these results is shown in Fig. 1 (opposite). On average slightly higher values are obtained by the calorimetric technique; the arithmetical mean of these results is 4-4 mg./l00 ml. by the calorimetric method and 3 9 mg./100 ml. by the enzymatic method. Therefore, these results differ slightly from the findings of Liddle and others (1959), who compared the present enzymatic technique with the colorimetric technique of Archibald (1957) and found that this colorimetric technique gave results which were on average 0-3 mg./100 ml. lower than those given by their enzymatic technique.

Serum urate concentrations in the Australian aboriginal.

“…This was chosen because it was one of the largest groups reported and because the same biochemical technique of urate estimation was used. Their results were also comparable with those obtained for other groups (Hauge and Harvald, 1955;Stetten and Hearon, 1959;Popert and Hewitt, 1962;Hall, Barry, Dawber, and McNamara, 1967). This method of urate estimation depends upon the inherent absorbance of urate in the ultraviolet wavelength and the change which occurs when the urate is destroyed by the action of excess uricase.…”

Relation of serum uric acid to body bulk, haemoglobin, and alcohol intake in two South Pacific Polynesian populations.

“…This is in contrast with the findings in a small group of Polynesians in Hawaii whose SUA values were similar to those of Caucasians (Healey and others, 1966), and, from the dispositions of the populations, both genetic and environmental factors could be relevant. Despite their higher values, the South Pacific Polynesian groups show variations with age and sex that are essentially similar to those in population groups of European origin (Mikkelsen and others, 1965;Popert and Hewitt, 1962), except for the absence of a fall in the fourth decade among women.…”

“…The graph suggests that a rise in female values with age occurs only after the menopause. In Caucasian populations a slight fall in mean female values from the third to the fourth decades has been observed (Mikkelsen, Dodge, and Valkenburg, 1965;Popert and Hewitt, 1962), which was not seen in either ofthe Polynesian groups, nor in a group of New Zealand Maoris studied previously (Prior, Rose, and Davidson, 1964). It is possible that this feature has been obscured by inaccuracy in the reported ages of the Polynesians.…”

Hypertension and Hyperuricæmia

“…In these 2 patients the uric acid pool size was 1,426 mg and 1,777 mg respectively, figures which are above accepted normal limits (upper limit of normal approximately 1,350 mg) (Sorensen 1960), while the corresponding uric acid turnover rates of 521 mg/24 h and 661 mg/24 h were within normal limits (upper limit of normal is approximately 950 mg/24 h) (Sorensen 1960 The incidence of hyperuricaemia in the 298 patients first attending the clinic, and with a blood urea below 40 mg/100 ml is 20%, or some three times the incidence in the general population (Popert & Hewitt 1962). There does not appear to be any correlation between the severity of the hypertension as indicated by the two measurements we have chosen, and the presence of hyperuricvmia, as has been suggested by Itskovitz & Sellers (1962).…”

“…They all show a peak at between 4-5 and 5 mg/100 ml and an almost gaussian curve though with slight positive skew deviation. In the population of Wensleydale, examined by Popert & Hewitt (1962), the serum uric acid, estimated by the enzymatic method of Liddle et al (1959) had a modal value of 3-5 mg/100 ml in women and 4-5 mg/100 ml in men. The frequency distribution of individuals aged 15-44 showed a gaussian curve in females but there was a positive skew in males.…”