Tuesday, December 03, 2013

About Gout

Fields of chili peppers near Jhuolan.

If you've lived in Taiwan for any length of time, you've encountered gout. I know several foreigners who struggle with it. Apparently Taiwan is number one in the world as new research observes gout has strong inherited aspect:
The oldest recorded disease in medical history, gout, has long thought been thought to be a result of an overindulgent lifestyle; excessive drinking and meat consumption leads to deposits of uric acid in the joints, causing debilitating pain. But new research done in Taiwan, where gout is most prevalent in the world, adds to the body of evidence that while gout may be a self-inflicted "rich man's disease," it is also very hereditary.

Previous research indicates that nearly 4 percent of the 23 million people in Taiwan have gout. For the latest study, The University of Nottingham examined data from 4.2 million families and found compelling evidence that the disease clusters in families, with an increased risk of gout in individuals who have immediate or secondary family members that also suffer from gout.
Not only does gout afflict more people here, they get it at younger ages. FocusTaiwan summarized:
Chen Shih-yang, director of Country Hospital's gout treatment center, told a medical conference that the age at which people are contracting gout in Taiwan has fallen markedly over the past 30 years.

Based on 40,000 data entries on gout patients he has accumulated since 1981, Chen said gout occurred mainly among men in their 50s and 60s in the 1980s but grew increasingly prevalent among men in their 30s in the 1990s and among men in their 20s in recent years.

Today, Chen said, 20-somethings account for 20 percent of Taiwan's gout population, an unheard of percentage two decades ago.
Before I started biking my doctor warned me that I was at risk for gout; fear of it was one of the factors that put me on a bike (my numbers have since normalized). Gout also runs rampant among local aborigines and indeed, this study and this one have identified gout-related genetic traits. This study opens:
That there is a high prevalence of gout disease among adult Taiwan aborigines is well known, with incidences ranging from 15 to 44% documented for Atayal men aged over 40 years, followed by Bununs (28.1%) and Paiwans and Tsou tribes (> 5%)1,2. In addition to high prevalence of the disease itself among aboriginal tribes, hyperuricemia is also known to be an asymptomatic feature among the adults2 and children3, but not all the subtribes of Taiwan aborigines suffer from gout. According to Bellwood4, the ancestral homeland of Austronesians was the agricultural heartland of Southeast Asia, from where they first radiated to Formosa (Taiwan; 4000 BC), then western Polynesia (1200 BC), central Polynesia (200 BC), and New Zealand (800 AD). Studies have shown male Micronesians to have prevalence of hyperuricemia ranging from 21 to 64%5-7, and in male Polynesians the figure ranges from 24.3 to 49%8,9. This is higher than in male Caucasians (6 to 23%)10-12, suggesting a direct association with gout.
Gout is also a risk factor in other diseases, such as chronic kidney disease. Among Asian doctors you often hear that soy foods cause gout, but the good news is that this review of studies on the soy-gout connection finds that there is none. So enjoy your tofu, and get on a bike!
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Domenic said...

Top Ten post, if for the rhyming title alone. Looking forward to "Diabetes Treatise." Ride on!

Anonymous said...

Filipino Americans are infamous for having gout. Given DNA analysis is putting Austronesian blood in an average Taiwanese at approximately 15%, and given Taiwan is much more affluent, not surprising Taiwan holds the crown for this disease of kings.

If the Filipinos become as wealthy as Taiwan, there's no doubt they would take over as the king of gout.