Wednesday, 13 April 2016

Most Common Disease of 50+: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Gout: The Risk Factors

Kyle J. Norton (Scholar and Master of Nutrients, all right reserved)Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(*).

Types of Musculo-Skeletal disorders in elder

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Gout mostly effected one joint is an acute and recurrent condition of arthritis as a result of uric acid building up in blood, inducing joint inflammation.

                      Causes and risk factors
B. Risk factors
1. Improper diet
If you body can not get rid uric acid quickly, intake foods with high levels of purine such as Alcohol, Beverages, Beer, Anchovies, Smelt, Fish, Eggs, Herring, Mackerel, Sardine, Sweetbread, Liver, Kidney, etc., is at increased risk of gout(7)(8)(10). Several dietary factors increased the risk of incident gout, including meat intake, seafood intake, sugar sweetened soft drinks, and consumption of foods high in fructose(10).

2. Alcohol consumption
Dr. Singh JA and scientists at the Birmingham VA Medical Centre, indicated, of the 751 titles and abstracts, 53 studies met the criteria and were included in the review. Several risk factors were studied. Alcohol consumption increased the risk of incident gout, especially beer and hard liquor(10)(7).
 Others suggested that combined with their activities as urinate transporters and their strong associations with serum uric acid concentrations,

3. Medical conditions
Hypertension, renal insufficiency, hypertriglyceridemia, hypercholesterolemia, hyperuricemia, diabetes are associated to increased risk of gout(10). Patient with Chronic kidney disease are at higher risk of gout as a result of Serum uric acid control in gout was poor among patients without CKD and even worse among those with CKD(11). Distinct group differences by content of uric acid seem to arise from early onset of chronic renal failure in women.

4. Medication
Gout is also drug-related(21). Thiazide and loop diuretics users are at increased risk of gout(12)(10), according to Johns Hopkins University Bloomberg School of Public Health.

5. Race
Some ethnic groups are particularly susceptible to gout, probaby due to genetic predisposition(13)(14).
6. Age and sex  are associated to risk of the develop of gout(14)(15).

7. Genetics
GLUT9 and ABCG2 appeared to be important modulators of uric acid levels and likely of the risk of gout. Together with a growing list of environmental risk factors, these genetic data add considerably to our understanding of the pathogenesis of hyperuricemia and gout(16)(17)(19).

8. Family history 
Accoridng to the total of 543 cases of juvenile gout from the Ho-Ping Gout Database, and 5269 gouty cases with onset age of 40 to 50 years, family history is associated to increased risk of gout(18)(19)
9. Obesity, over weight, weight change
 Obesity and overweight are associated with a higher risk of incident gout and/or gout flare(10)(19).
Higher adiposity and weight gain are strong risk factors for gout in men, while weight loss is protective(5).

10. Menopause
Early menopause is associated with a higher risk of incident gout and/or gout flare(10). According to the16 years of follow-up (1 240 231 person-years), 1703 incident gout cases, conducted by the Taipei Municipal Hospital Gout Research Group, compared with premenopausal women, postmenopausal women had a higher risk of incident gout. Risk of gout is decreased among postmenopausal hormone users(22).

11. Recent surgery or trauma
According to Cleveland Clinic, risk of early postoperative gout is higher after bariatric surgery in comparison of patients undergoing other procedures(23)(24). There is a report of monoarticular gout following trauma in Medical College of Wisconsin literature(25).

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(*) Musculoskeletal disorders and disability in persons aged 85 and over: a community survey. by van Schaardenburg D1, Van den Brande KJ, Ligthart GJ, Breedveld FC, Hazes JM.(PubMed)
(4) Tophi as first clinical sign of gout by Thissen CA1, Frank J, Lucker GP.(PubMed)
(7) [Hyperuricemia and gout; the role of diet].[Article in Spanish]by Álvarez-Lario B1, Alonso-Valdivielso JL2.(PubMed)
(8) A perspective on diet and gout by Kedar E1, Simkin PA.(PubMed)
(10) Risk factors for gout and prevention: a systematic review of the literature by Singh JA1, Reddy SG, Kundukulam J.(PubMed)
(11) Chronic kidney disease in gout in a managed care setting by Fuldeore MJ1, Riedel AA, Zarotsky V, Pandya BJ, Dabbous O, Krishnan E.(PubMed)
(12) Diuretic Use, Increased Serum Urate and the Risk of Incident Gout in a Population-based Study of Hypertensive Adults: the Atherosclerosis Risk in the Communities Cohort by Mara A. McAdams DeMarco, MS, PhD,1 Janet W. Maynard, MD, MHS,2 Alan N. Baer, MD,2 Allan C. Gelber, MD, MPH, PhD,1,2 J. Hunter Young, MD, MHS,1,3 Alvaro Alonso, MD, MPH, PhD,4 and Josef Coresh, MD, PhD1,3(PMC)
(13) Global epidemiology of gout: prevalence, incidence and risk factors by Kuo CF1, Grainge MJ2, Zhang W3, Doherty M3.(PubMed)
(14) Gout: a review of nonmodifiable and modifiable risk factors by MacFarlane LA1, Kim SC2.(PubMed)
(15) The Toll-Like Receptor 4 (TLR4) Variant rs2149356 and Risk of Gout in European and Polynesian Sample Sets by Rasheed H1,2, McKinney C1, Stamp LK3, Dalbeth N4, Topless RK1, Day R5,6, Kannangara D5,6, Williams K5,6, Smith M7, Janssen M8, Jansen TL9, Joosten LA10, Radstake TR11, Riches PL12, Tausche AK13, Lioté F14,15, Lu L16, Stahl EA17, Choi HK16, So A18, Merriman TR1.(PubMed)
(16) Genetics of gout by Choi HK1, Zhu Y, Mount DB.(PubMed)
(17) ABCG2/BCRP dysfunction as a major cause of gout by Matsuo H1, Takada T, Ichida K, Nakamura T, Nakayama A, Suzuki H, Hosoya T, Shinomiya N(PubMed)
(18) Juvenile gout in Taiwan associated with family history and overweight by Chen SY1, Shen ML.(PubMed)
(19) Clinical features of familial gout and effects of probable genetic association between gout and its related disorders by Chen SY1, Chen CL, Shen ML, Kamatani N.(PubMed)
(20) Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study by Choi HK1, Atkinson K, Karlson EW, Curhan G.(PubMed)
(21) Hyperuricaemia and gout by Shipley M1.(PubMed)
(22) Menopause, postmenopausal hormone use and risk of incident gout by Hak AE1, Curhan GC, Grodstein F, Choi HK.(PubMed)
(23) The effect of bariatric surgery on gout: a comparative study by Romero-Talamás H1, Daigle CR1, Aminian A1, Corcelles R1, Brethauer SA1, Schauer PR2.(PubMed)
(24) Development of acute gouty attack in the morbidly obese population after bariatric surgery by Antozzi P1, Soto F, Arias F, Carrodeguas L, Ropos T, Zundel N, Szomstein S, Rosenthal R.(PubMed)
(25) Monoarticular gout following trauma: MR appearance by Ruiz ME1, Erickson SJ, Carrera GF, Hanel DP, Smith MD.(PubMed)

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