Gout, why does it prefer to torture men?

You must have heard of "gout" at some point. Gout is called gout because it really hurts! Speaking of pain, men are probably the ones who suffer more, because gout really likes to torture men more.

In the general population, more than 95% of gout occurs in men, while the incidence of gout in women is less than 5%, with a male-to-female ratio of nearly 20:1.

Why is the incidence of gout in men significantly higher than in women?

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Different hormones make men more susceptible to gout

The main cause of gout is hyperuricemia, and uric acid is the end product of purine metabolism in the human body. The kidney is the main pathway for uric acid excretion, and estrogen has the effect of promoting uric acid excretion. Premenopausal women have a large amount of estrogen secretion in their bodies, and the estrogen level in the blood is high, which can promote the excretion of uric acid by the kidneys and help lower the level of uric acid in the blood.

Correspondingly, the sex hormone level in men is mainly androgen. Since androgen reduces the excretion of uric acid from the renal tubules, the uric acid level in male plasma is relatively higher than that in premenopausal women of the same age.

However, it should be noted that the estrogen level of women after menopause decreases. As the testosterone level increases, the uric acid level in the body also increases accordingly. A previous study in the United States found that women's blood uric acid levels gradually increase around the age of 50. Therefore, postmenopausal women should also pay more attention to the risk of gout.

Men prefer these "gout packages"

Differences in eating habits are also an important reason for the difference in gout rates between men and women. Due to the nature of their work and social aspects, men have more opportunities to dine out than women, which increases the risk of hyperuricemia. When dining at parties, people often choose to drink beer or eat fatty meat, animal liver and other foods, which have a relatively high purine content, which will increase the burden of purine metabolism in the body and increase uric acid production.

Results from the China Prospective Study on Chronic Diseases show that the amount of alcohol consumed, the frequency of drinking, and the number of intermittent heavy drinkers have increased over the past 10 years, especially among young men. Alcohol not only increases the production of uric acid by increasing the turnover rate of adenine nucleotides, but also reduces the excretion of uric acid by the kidneys, raising blood uric acid levels.

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In addition, the intake of fructose-containing beverages also increased significantly when drinking. Although fructose-containing beverages do not contain purine, they can indirectly induce hyperuricemia. Increased intake of alcohol and fructose-containing beverages may help explain the increased risk of hyperuricemia in young men.

Gout is more common in overweight people

Men are more likely to be overweight than women

Obesity is a major contributing factor to a variety of chronic metabolic diseases. Studies have shown that obesity is associated with an increased risk of hyperuricemia and gout, and the proportion of overweight men is significantly higher than that of women.

Weight has always been considered a key determinant of blood uric acid levels, and being overweight or obese is a recognized risk factor for hyperuricemia. According to a study published by Professor Mu Yiming's team at the PLA General Hospital, according to the BMI classification of Chinese people, 34.8% of people are overweight and 14.1% are obese. Overweight and obesity are more common in men than in women, with 41.1% of men being overweight and 27.7% of women being overweight; 18.2% of men being obese and 9.4% of women being obese. The high obesity rate in men may also be an important reason why the incidence of high uric acid in men is higher than that in women.

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In summary, due to differences in hormone secretion and other physical differences, as well as different eating habits, the incidence of hyperuricemia or gout in men is relatively higher than that in women. For postmenopausal women, they should also pay attention to the increased risk of hyperuricemia or gout.

Both men and women should maintain good eating habits, control their weight, and exercise properly to prevent and control the occurrence of hyperuricemia or gout.

Author: Xie Jianjun, Graduate School of Medical College, Suzhou University, Jiangsu Province

Li Quanmin Department of Endocrinology, Chinese People's Liberation Army Rocket Force Special Medical Center

Reviewer: Tang Qin, Director of the Science Popularization Department of the Chinese Medical Association, National Health Science Popularization Expert