Racial and Gender Disparities Among Patients with Gout

Abstract

Gout affects 8.3 million Americans according to NHANES 2007–2008, roughly 3.9% of the U.S. population. Gout has significant impact on physical function, productivity, health-related quality of life (HRQOL) and health care costs. Uncontrolled gout is also associated with significant utilization of emergent care services. Women are less likely to have gout than men, but in the postmenopausal years the gender difference in disease incidence decreases. Compared to Whites, racial/ethnic minorities, especially blacks, have higher prevalence of gout. On the other hand, blacks are less likely to receive quality gout care, leading to a disproportionate morbidity. Women are less likely than men to receive allopurinol, less likely to get joint aspirations for crystal analyses for establishing diagnosis, but those on urate-lowering therapy are as/more likely as men to get serum urate check within 6-months of initiation. While a few studies provide the knowledge related to gender and race/ethnicity disparities in gout, several knowledge gaps exist in gout epidemiology and outcomes differences by gender and race/ethnicity. These should be explored in future studies.

Differences in Terminal Hospitalization Care Between U.S. Men and Women

“…Men and women receive different health care in many settings, including inpatient and outpatient care, [1][2][3] and in cardiovascular diseases, stroke, and cardiopulmonary resuscitation. [4][5][6][7][8][9][10] The direction of these differences is inconsistent.…”

Hyperuricemia and chronic kidney disease: an enigma yet to be solved

“…4 In terms of ethnic and gender differences, Asian patients with end-stage renal disease (ESRD) present higher rates of HUA 5 , and men have a higher risk of HUA and gout in the general population. 6 Data from several studies have associated HUA with increased incidence and/or progression of CKD. Diabetes is one of the leading causes of CKD and HUA has been associated with the pathogenesis of the microvascular complications of diabetes.…”

Gout in Pregnancy: A Case Report and Review of the Literature

“…This low rate, when compared to men of the same age, is thought to result from high estrogen levels, which leads to increased uric acid excretion and resultant decreased serum uric acid levels [2,3,19]. Higher estrogen levels during pregnancy are thought to prove protective against an acute gout flare, while the falling levels in the postpartum period may lead to increased risk for disease exacerbation.…”

“…Especially African-American, Hmong Chinese and Maoris seem to have a higher prevalence when compared to Caucasians. The combined effect of gender and race is however unclear, but Hmong women had a similar gout prevalence when compared to Caucasian women [19]. …”