Gout 浙大医学院附属二院任跃忠
Gout 浙大医学院附属二院 任跃忠
Background y Gout is a common disorder of etabolism that can lead to deposition of monosodium urate(MSU) crystals in soft tissue, recurrent episodes of debilitating i oint inflammation, and, if untreated, joint destruction and renal damage Gout is definitively diagnosed based on t he demonstration of in asp irated synovial fluid 浙医二院
2 浙医二院 Background Gout is a common disorder of uric acid m etabolism that can lead to deposition of monosodium urate (MSU) crystals in soft tissue, recurrent episodes of debilitating j oint inflammation, and, if untreated, joint destruction and renal damage. Gout is definitively diagnosed based on t he demonstration of urate crystals in asp irated synovial fluid
Epidemiology o United States statistics-The National Health and Nutrit ion Examination Survey(2007-2008)estimated a new pre valence for gout and hyperuricemia. Gout rates were repo rted as 5. 9% among men and 2% among women (etrog enic hormones have a mild uricosuric effect). The prevale nce rate of hyperuricemia was noted as 21.2% for men an d 21.6% for women Racial differences in incidence-In the United States, t he incidence of gout is 3.11 per 1000 person-years in Afri can Americans and 1.82 per 1000 person years in whites -Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hy the US general population!The\ Health and Nutrtion Examination Survey 2007-2008.Arthritis Rheum. Oct 2011: 63(103-3136-41
3 浙医二院 Epidemiology United States statistics---The National Health and Nutrit ion Examination Survey (2007-2008) estimated a new pre valence for gout and hyperuricemia. Gout rates were repo rted as 5.9% among men and 2% among women. (estrog enic hormones have a mild uricosuric effect). The prevale nce rate of hyperuricemia was noted as 21.2% for men an d 21.6% for women. Racial differences in incidence---In the United States, t he incidence of gout is 3.11 per 1000 person-years in Afri can Americans and 1.82 per 1000 person years in whites; --------Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: The National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. Oct 2011;63(10):3136-41
Epidemiology As a rule, uric acid levels are elevated for 20 years before the onset of gout In men, the peak age of onset of gout in men is in the four th to sixth decade of life. However, onset may occur in me n in their early 20s who have a genetic predisposition and lifestyle risk factors. In women, peak age of onset is in the sixth to eighth decade of life Tophi are typically detectable clinically approximately 10 y ears after the first gout attack Olaniyi-Leyimu BY. Consider gout in patients with risk factors, regardless of age. Am Fam Physician, Jul 15 2008, 78(2): 176 院
4 浙医二院 Epidemiology As a rule, uric acid levels are elevated for 20 years before the onset of gout. In men, the peak age of onset of gout in men is in the four th to sixth decade of life. However, onset may occur in me n in their early 20s who have a genetic predisposition and lifestyle risk factors. In women, peak age of onset is in the sixth to eighth decade of life. Tophi are typically detectable clinically approximately 10 y ears after the first gout attack. Olaniyi-Leyimu BY. Consider gout in patients with risk factors, regardless of age. Am Fam Physician. Jul 15 2008;78(2):176
Etiology Uric acid is an end-stage by-product of purine metabolism. Human s remove uric acid primarily by renal excretion. ( the saturation level of 6.8 mg/dL) Ninety percent of patients with gout... underexcretion The remaini ng patients.overproduction. In rare cases, overproduction., due to a genetic disorder ( hypoxa nthine-guanine phosphoribosyl transferase.次黄吟鸟酸长精基转移 deficie ncy, glucose-6-phosphatase deficiency, fructose 1-phosphate ald olase醛缩酶 deficiency) Chronic urate nephropathy can result from the deposition of urate c rystals in the medullary interstitium and pyramids, resulting in an inf lammatory reaction that can lead to fibrotic changes 浙医二院
5 浙医二院 Etiology Uric acid is an end-stage by-product of purine metabolism. Human s remove uric acid primarily by renal excretion. (the saturation level of 6.8 mg/dL ) Ninety percent of patients with gout … underexcretion. The remaini ng patients …overproduction. In rare cases, overproduction .., due to a genetic disorder. ( hypoxa nthine-guanine phosphoribosyl transferase次黄嘌呤鸟嘌呤磷酸核糖基转移酶 deficie ncy , glucose-6-phosphatase deficiency , fructose 1-phosphate ald olase醛缩酶 deficiency) Chronic urate nephropathy can result from the deposition of urate c rystals in the medullary interstitium and pyramids, resulting in an inf lammatory reaction that can lead to fibrotic changes