Serum uric acid levels and gout: what does this herald for the population?
OBJECTIVE
To compare the Rome and New York criteria for gout.


METHODS
The Rome and New York criteria were compared in 59 patients with gout and in 761 with non-gout by calculating statistical indices such as sensitivity, specificity, relative value (sensitivity + specificity) and the log-likelihood ratio.


RESULTS
The best individual criterion was one or more attacks of podagra (New York version) which had a relative value of 194. In contrast, the presence of a tophus was the least valuable criterion with a discriminatory value which was less than three times the most valuable (podagra). The rarity with which either response to Colchicine therapy or measurement for urate crystals were sought makes them poor criteria. Serum uric acid (SUA) followed an approximate Normal Distribution in both sexes, although there were some interesting differences across age strata. In males, SUA showed a progressive rise with age interrupted by a hiccup in the mid-40s. In females, SUA fell slowly as menstruation started, followed by a gradual postmenopausal rise. The mean SUA in males was 294 mumol/l (95% CI = 278-330 mumol/l) and in females 230 mumol/l (95% CI = 224-236 mumol/l).


CONCLUSIONS
Despite higher levels of SUA in gouty patients, there was no lower level of SUA from which gout was not diagnosed, which vindicates its removal from the New York criteria set.
Division of Public Health, Nuffield Institute for Health, University of Leeds, U.K.
A S
AS
Rigby
P H
PH
Wood
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006073:Gout / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid