Feb. 8, 2023 -- Gout in people who have a brother, father, sister, or mother with the condition, a form of arthritis that often causes sudden, severe pain in the joints, is mostly driven by genetic makeup but can worsen significantly if they also drink heavily or carry excess weight.
Although gout can affect anyone, having a first-degree relative with the condition raises risk by nearly two-and-a-half times compared to someone without an affected first-degree relative.
Results from a recent study carried out among people in South Korea looked at the possible reasons for gout when it runs in families. They asked whether it was driven by genetics, or behavior such as high alcohol consumption, or possible lifestyle that might lead to being overweight or having obesity.
Gout occurs when levels of uric acid in the blood are high, leading to the collection of sharp crystals in and around the joints that cause sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, often in the big toe.
More than 8 million Americans have gout, and it occurs more often in men than in women.
The study, which was published in Arthritis Care and Research, the journal of the American College of Rheumatology, also found that in people who have both a first-degree relative with gout and carry excess weight, their risk of gout rises to between four to over six times that of the general population without gout in the family or a high body mass index, or BMI. The risk rises with the amount of excess weight and is highest in individuals with obesity, or a BMI that's 30.0 or higher.
If someone is a heavy drinker and they have a first-degree relative with gout, then their risk increases nearly three times that of the general population without gout or a tendency to heavy drinking.
The link with food and drink comes from the buildup of uric acid in the blood, which is a breakdown product of purine, a chemical found in certain foods including beer and wine, liver and other organ meats, some seafoods and fructose-containing soft drinks.
"This suggests that most of the familial impact is in fact genetic rather than due to shared environmental factors and is an important finding," says Abhishek Abhishek, MD, a professor of rheumatology at Nottingham University Hospitals NHS Trust in the U.K.
"People with a first-degree relative with gout should minimize their alcohol intake and maintain a healthy body weight to reduce their risk of developing gout in the future," he says.
Abhishek notes that an "aggressive management of excess weight and high alcohol consumption may prevent the onset of gout or improve its outcomes in those that already have this condition."
Among individuals with an affected brother, they had a three times greater risk than someone without an affected brother. Those whose father had the condition had a nearly 2.5 times higher risk, while those with a sister with gout had nearly twice the risk. Those whose mother had gout had just over 1.5 times the risk of someone whose mother did not have gout.
"People just need to lay off the alcohol to reduce risk of gout. We don't get to choose our parents, so most of us should reduce our weight and minimize alcohol," says Bruce Rothschild, MD, a professor of medicine at IU Health and a research associate at Carnegie Museum in Pittsburgh, PA.