How is hyperuricemia defined? What are the most common factors associated with hyperuricemia and gout?
Hyperuricemia is defined by a serum urate concentration exceeding its solubility threshold, promoting the formation and deposition of MSU. At a physiologic pH, hyperuricemia is defined as a serum concentration >6.8 mg/dL (>360 μmol/L). Serum urate concentrations increase with age and are higher in men than in women, increasing in association with the onset of puberty in young men and menopause in women (the latter owing to uricosuric properties of estrogen). Gout is rare in men aged <25 years and in premenopausal women; when it occurs in these populations, it is often attributed to an inherited defect in purine metabolism, alcohol use, and/or renal insufficiency including familial juvenile hyperuricemic nephropathy or medullary cystic kidney disease. In addition to older age and male sex, other factors commonly associated with hyperuricemia and gout include obesity, hypertension, and other elements of metabolic syndrome, high purine intake, a family history of gout, alcoholism, renal insufficiency, the use of selected medications such as low-dose aspirin, diuretics, and cyclosporine among others.
