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Hyperuricaemia in the Pacific: why the elevated serum urate levels?
Anna L Gosling1, Elizabeth Matisoo-Smith, Tony R Merriman
1Department of Anatomy, Allan Wilson Centre for Molecular Ecology and Evolution, University of Otago, PO Box 913, Dunedin, New Zealand, anna.gosling@anatomy.otago.ac.nz.
Rheumatology International
|January 1, 2014
Summary
Pacific Islanders, especially Polynesians, have higher serum urate levels due to genetic factors. This may be linked to evolutionary adaptations, possibly driven by malaria exposure, offering a protective advantage.
Area of Science:
- Human genetics
- Population health
- Evolutionary biology
Background:
- Pacific Island populations, particularly Polynesians, exhibit a high prevalence of hyperuricemia and gout.
- This is attributed to inherently higher serum urate levels and a genetic predisposition within these groups.
- While elevated urate can be pathological, it also plays crucial roles in human health, including antioxidant, neuroprotective, and immune functions.
Purpose of the Study:
- To review global urate levels, focusing on Island Southeast Asia and the Pacific.
- To explore evolutionary explanations for elevated serum urate in Pacific populations.
- To investigate the role of ancestry and historical environmental factors in hyperuricemia.
Main Methods:
- Literature review of urate levels worldwide.
- Analysis of population settlement history in the Pacific.
- Hypothesis generation based on evolutionary and genetic principles.
Main Results:
- Pacific populations demonstrate significantly higher serum urate levels compared to global averages.
- Genetic factors are strongly implicated in the predisposition to hyperuricemia in these groups.
- Historical exposure to malaria is proposed as a potential selective pressure for urate-elevating variants.
Conclusions:
- Ancestry plays a significant role in hyperuricemia prevalence among Pacific Islanders.
- Genetic selection for high serum urate may have conferred an advantage, potentially related to malaria resistance.
- Understanding these evolutionary factors is crucial for managing hyperuricemia and gout in these populations.
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