Environmental Triggers of Hyperuricemia and Gout

Abstract

Gout is the most prevalent type of inflammatory arthritis worldwide and environmental factors contribute to hyperuricemia and risk for gout flare. Causes of hyperuricemia include increased purine consumption from meat, alcohol, and high fructose corn syrup as well as medications such as cyclosporine, low-dose aspirin, or diuretics. Triggers for gout flares include increased purine consumption and medication use such as urate lowering therapy and diuretics. Environmental exposures including lead exposure, particulate matter exposure, temperature fluctuations, and physiologic stress have been found to trigger flares. In the right clinical scenario, these factors should be considered when treating gout patients.

Keywords: Diet; Environmental exposures; Epidemiology; Gout; Hyperuricemia.

Figure 1.. Environmental factors associated with hyperuricemia, serum urate lowering, and gout flare risk

Hyperuricemia results as an imbalance between uric acid its excretion via the kidneys or gastrointestinal tract and may result from environmental exposures that tip the balance, particularly those related to increased purine consumption (e.g., diet, alcohol) or factors leading to diminished urate excretion (e.g., lead intoxication, medications)