Risk factors for gout: a hospital-based study in urban black South Africans.
The clinical features of 90 Black South African patients with gout seen at a large urban hospital were reviewed. The mean age of the patients was 54.3 and 55.3 years for men and women, respectively. The male:female ratio was 3.3:1. All except one of the women were postmenopausal. Seventy-nine percent of patients were from the lower income groups of "blue collar" workers, old-age pensioners or the unemployed. Polyarticular gout was observed in 44.4% of the patients. Tophi were noted in 51.1% of patients but none had a history of renal calculi. Risk factors were assessed by comparing the gouty patients to an equal number of age- and sex-matched hospital controls. Case-control analysis showed a "white collar" occupation (odds ratio = 7.4), obesity (odds ratio = 5.3), alcohol intake (odds ratio = 3.5) and hypertension (odds ratio = 3.3) to be significant risk factors for gout in the overall group of both men and women. In the subgroup of men only, obesity (odds ratio = 7.8), a "white collar" occupation (odds ratio = 6.4), hypertension (odds ratio = 4.9) and alcohol intake (odds ratio = 3.5) were similarly associated with gout. In women, a history of alcohol intake was the only significant risk factor associated with gout (odds ratio = 5.0). These findings suggest that in a population where gout was previously rare, changing dietary habits and lifestyle, together with improving socioeconomic conditions are contributing significantly to the increasing prevalence of the disease.
Tikly
M
M
Department of Medicine, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
Bellingan
A
A
Lincoln
D
D
Russell
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D044383:Black People; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006073:Gout / Q000208:ethnology* / Q000209:etiology / Q000473:pathology; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension; D008297:Male; D008875:Middle Aged; D009765:Obesity; D009790:Occupations; D017698:Postmenopause; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D014505:Urban Population