The latest meta-analysis shows that the number of adult patients with hyperuricemia among our compatriots has exceeded 200 million, and the number of gout patients has exceeded 100 million. In everyone's impression, the increase in uric acid and the resulting gout mainly occur in middle-aged men who have more oil and water and like to eat and drink. The question arises, is the risk of hyperuricemia really a gender difference? What is the reason behind it? What are the characteristics and effects of elevated uric acid levels in women? What are some special things to be aware of? Let's solve your doubts now.
The results of the current study show that hyperuricemia is caused by a combination of genetic and life factors. Studies have found that hyperuricemia, with familial clustering, patients with gout, immediate family members will have 10% to 25% of hyperuricemia. Another feature is that the younger the patient with gout, the more pronounced the family history is, for example, 50% of gout patients under the age of 25 have a family history. Usually, patients with a family history of gout, who have an earlier age of onset, are more severely ill, and are less sensitive to drug therapy, in addition, the genetic predisposition of women is more pronounced. Therefore, if a woman develops hyperuricemia before menopause, more attention should be paid to preventing damage to kidney function.
There are significant gender differences in the incidence of hyperuricemia and gout. Currently, the incidence of hyperuricemia is about 21.6% in men and 8.6% in women. Among patients with gout, the ratio of men to women is about 15 to 1, the average age of disease is 48 years old, and the age of onset of gout in women is later than that of men, possibly due to the decline in estrogen levels after menopause. The study found that gout in women before menopause usually presents as a genetic disorder, such as familial adolescent hyperuricemia, which increases the risk of gout if women develop gestational diabetes or kidney disease.
There are also obvious gender differences in the predisposing factors for gout. The common triggers of gout in men account for about 25% of alcohol, about 23% of the diet of high purines, and about 6% of strenuous exercise. Common causes of gout in women, a high-purine diet accounts for about 17%, sudden cold accounts for 11%, and strenuous exercise accounts for about 9%.
The location of gout in men and women is also different. The first part of male attack, mainly the first metatarsophalangeal joint of the foot, the female first joint, mainly the ankle and knee joints, and the proportion of female gout affecting the upper limb joints is more than that of men, but the proportion of toes affected is lower than that of men. In addition, female gout patients have a higher degree of disability and renal impairment, and are often accompanied by hypertension and diabetes.
Hyperuricemia and gout can seriously affect fertility. In men, hypogonadism, decreased testosterone levels, and decreased sperm quality can be caused. In women, hyperuricemia may affect ovulation because, uric acid is contained in the follicular fluid, and hyperuricemia may disrupt the follicular plasma barrier. Studies have shown that elevated blood uric acid levels during pregnancy are closely related to preeclampsia and gestational diabetes. In addition, some therapeutic drugs, such as colchicine, may cause azoospermia, and the effects of therapeutic drugs on women's reproductive health are currently insufficient in research.
In women with hyperuricemia and gout, treatment is more difficult. From the perspective of drug selection, the effect of febustat is better than that of low-dose allopurine. If a woman develops gout during pregnancy or lactation, glucocorticoids are usually needed, however, colchicine should be avoided. If the patient has gestational hypertension or gestational diabetes mellitus, glucocorticoids need to be cautiously or contraindicated, and only nonsteroidal anti-inflammatory drugs can be selected to treat acute attacks of gout. Allopurine is a drug with teratogenic effects and can be secreted through breast milk, so female patients should avoid it during pregnancy or lactation. Overall, the incidence of hyperuricemia and gout in women is lower than in men, but symptoms and health damage may be more severe, and there are many contraindications to drug selection. Therefore, female friends should pay more attention to prevention, especially those with family history, should actively improve their lifestyle, at the same time, regular examinations, timely detection and control of the disease.
Whoever loves, pass on health to whom.