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Published on: February 8, 2019
Female gout: age and duration of the disease determine clinical presentation
Sergio García-Méndez1, Erick Beas-Ixtláhuac, Claudia Hernández-Cuevas
1Rheumatology Department, Hospital General de México, México City, México.
Insights
This study found that factors linked to female gout are more associated with age than sex. Renal function evaluation in women with gout should consider gender, as premenopausal women showed a higher frequency of lithiasis.
Area of Science:
- Rheumatology
- Nephrology
- Epidemiology
Background:
- Gout is a complex metabolic disease affecting both men and women.
- Understanding sex-specific differences in gout presentation and comorbidities is crucial for effective management.
- Previous research suggests potential gender-based variations in gout's clinical course and associated conditions.
Purpose of the Study:
- To compare clinical data and associated diseases between women and men diagnosed with gout.
- To analyze differences in gout onset and renal function between genders, controlling for age and disease duration.
- To investigate the characteristics of premenopausal women with gout.
Main Methods:
- A case-control study included 37 women and 37 age- and disease-duration-matched men with gout.
- Data collected included clinical variables, comorbidities, and renal function assessed by creatinine clearance, Modification of Diet in Renal Disease (MDRD), and Cockcroft-Gault equations.
- Patients were diagnosed using American College of Rheumatology criteria.
Main Results:
- No significant differences were observed in gout or associated metabolic diseases between men and women.
- Females exhibited lower creatinine clearance when calculated universally, but no significant differences emerged when sex-specific equations were applied.
- Thirty-five percent of women were premenopausal at gout onset, with a higher frequency of lithiasis compared to postmenopausal women.
Conclusions:
- Factors previously linked to female gout appear to be age-related rather than sex-specific.
- Gout patients in this cohort presented at a younger age, irrespective of gender.
- Gender-specific considerations are important for assessing renal function in women with gout, and premenopausal women may have unique comorbidity patterns.
Objective:
This study aimed to compare data and associated diseases between women and men with gout paired for age and duration of the disease.
Methods:
Consecutive patients from outpatient gout clinics of 2 rheumatology departments were included in this case-control study. We identified 37 women with gout diagnosis and paired them by age and duration of the disease with 37 men with gout (American College of Rheumatology criteria). Variables were clinical data, associated diseases, and renal function evaluated by 3 methods: creatinine clearance, modification of diet in renal disease, and Cockcroft-Gault.
Results:
Mean (SD) age was 54.47 (15.13) years in women versus 53.52 (15.23) years in males, and mean (SD) age at onset 46.77 (16.63) years versus 45.62 (16.16) years in women and men, respectively. Hypertension was found in 26 (73%) of 37 women and in 27 (70%) of 37 men, previous diuretics was found in only 1 man, and no significant differences were found between women and men in gout or associated metabolic diseases. Females had lower creatinine clearance than males did (49.8 [29.7] vs. 67.1 [35.5] mL/min, P = 0.039). But, when it was calculated by methods considering sex, there were no significant differences (Cockcroft-Gault 66.4 [37.6] vs. 78.8 [43.8] mL/min [P = 0.2] and modification of diet in renal disease 73.8 [64.6] vs. 73.1 [35.0] mL/min [P = 0.9], females vs. males, respectively). Thirteen women (35%) were premenopausal at onset, 2 had familial history of gout, and 2 had history of lithiasis; other variables were not different from postmenopausal women.
Conclusions:
Factors previously associated to female gout seem to be more related to age than to sex or to the disease itself. In our country, patients with gout (males and females) are younger at onset. Gender should be considered to evaluate renal function in females with gout. One third of our female patients with gout were premenopausal and had unexpected higher frequency of lithiasis; no other differences with postmenopausal women were found.
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