title: Has the clinical spectrum of gout changed over the last decades?
abstract: OBJECTIVE
  To evaluate if the clinical spectrum of gout has changed over the last decades, a cohort of 107 patients was studied in relation to the date of disease onset and of presentation to our Institution.
  
  
  METHODS
  The structured questionnaires of 107 consecutive patients with gout seen between 1989 and 2009 were retrospectively reviewed. Patients were divided into two subgroups according to the year of the first acute arthritis attack: (a) patients with gout onset dating back to 1967-2001, and (b) patients with gout of later (2002-2009) onset. The patients were also subdivided according to the date of their first admission to our Institution: 1989-2006 and 2007-2009 admissions.
  
  
  RESULTS
  The male to female ratio changed from 11.3 in the patients who had the first attack before 2002 to 2.4 in the second onset group (p=0.02). A family history of gout was slightly more frequent in the second subgroup (22.7% vs. 6.4%, p=0.05). The mean number of acute attacks was higher in patients seen before 2002 (p=0.01). Synovial fluid was examined more frequently in the subgroup visited for the first time after 2006 (p=0.001).
  
  
  CONCLUSIONS
  Our data indicating that the patients' sex ratio has changed over time, with women more frequently affected, could be of importance to clinicians who often believe that gout is a disease affecting males only. The increased utilisation of synovial fluid analysis suggests a closer attention to the disease in recent years. Clinicians should be aware that gout is increasingly affecting women.
authors.affiliation: Clinica Reumatologica, Dipartimento di Medicina Interna, Università di Genova, Italy. gzampogna@libero.it
authors.forename: G
authors.initials: G
authors.lastname: Zampogna
authors.forename: R
authors.initials: R
authors.lastname: Andracco
authors.forename: M
authors.initials: M
authors.lastname: Parodi
authors.forename: M
authors.initials: M
authors.lastname: Cutolo
authors.forename: M A
authors.initials: MA
authors.lastname: Cimmino
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology*; D015331:Cohort Studies; D005192:Family Health / Q000706:statistics & numerical data*; D005260:Female; D006073:Gout / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D013582:Synovial Fluid / Q000502:physiology*