© 1994 British Society for Rheumatology
research-article |
POLYNESIAN WOMEN ARE ALSO AT RISK FOR HYPERURICAEMIA AND GOUT BECAUSE OF A GENETIC DEFECT IN RENAL URATE HANDLING
*Purine Research Laboratory, UMDS Guy's Hospital London
Department of Renal Medicine, Wellington Hospital
Department of Nutrition and Dietetic Services, Wellington Hospital
¶Department of Clinical Chemistry, Wellington Hospital
The Mitsubishi Health Centre Porirua, New Zealand
Correspondence to:
Correspondence to: Dr H. A. Simmonds, Purine Research Laboratory, Clinical Science Laboratories, 18th Floor GT, Guy's Hospital, London Bridge, London SE1 9RT.
The prevalence of asymptomatic hyperuricaemia among Polynesian women (Maoris, Cook Islanders, Samoans, Tongans) was high—44%. This hyperuricaemia resulted from a reduced fractional uric acid clearance (FEur: uric acid clearance factored by creatinine clearance x 100—6.7 ± 1.5%) compared with the FEur in healthy UK women (12.8 ± 2.9%). This reduction in FEur was not as great as that in young UK women with familial juvenile hyperuricaemic nephropathy (FJHN: 5.1 ± 1.5%) and was not associated with impaired renal function. The FEur in the normouricaemic Polynesians (9.7 ± 1.9%) was also lower than that in healthy UK women (12.8 ± 2.9%).The reduced FEur in these Polynesian women supports the hypothesis that indigenous Pacific races share a similar genetic defect in renal urate handling to that reported as the basis for the susceptibility to hyperuricaemia in Maori men. Neither alcohol nor hypertension contributed to this. This study also confirmed that, compared with their European counterparts, Polynesian women have a high purine intake and a strong tendency to obesity which increases with age. These factors, together with the reduced FEur, put them at added risk for gout. However, the reduction in FEur, was not as great as that reported for the normouricaemic or asymptomatic hyperuricaemic Maori male (4.9 ± 1.5% and 3.9 ± 1.4%, respectively), confirming the same sex difference in renal urate handling in adult Polynesians as in caucasians.
KEY WORDS: Polynesians, Gout, Hyperuricaemia, Renal function, Renal urate handling, Fractional uric acid clearance, Familial juvenile hyperuricaemic nephropathy, Obesity
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