You must have heard of “gout”. Gout is named gout because it really hurts! Speaking of pain, it is probably more painful for men because gout really loves to torment men.
Among the general population, over 95% of gout cases occur in men, while the occurrence rate of gout in women is less than 5%, with a male-to-female ratio close to 20:1.
Why is the incidence of gout significantly higher in men than in women?
Different hormones,
make men more prone to gout.
The main cause of gout is hyperuricemia, and uric acid is the end product of purine metabolism in the body. The kidneys are the main route for uric acid excretion, and estrogen promotes uric acid excretion. Premenopausal women have higher estrogen levels in their bodies, which can facilitate kidney excretion of uric acid, helping to lower blood uric acid levels.
In contrast, male bodies primarily have androgens, and since androgens reduce uric acid excretion from the renal tubules, the uric acid levels in male plasma are relatively higher than in premenopausal women of the same age.
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However, it is important to note that postmenopausal women experience a decrease in estrogen levels, accompanied by an increase in testosterone levels, leading to a corresponding increase in uric acid levels in the body. A previous study in the United States found that around the age of 50, women experience a gradual increase in blood uric acid levels. Hence, postmenopausal women should also pay more attention to the risk of gout.
Men prefer these “gout packages”
Dietary habits differences are also key factors in the gender difference in gout incidence. Due to work nature and social interactions, men have more opportunities for dining out compared to women, increasing the risk of hyperuricemia. During social gatherings, people often choose to consume beer or foods high in purines like fatty meat, animal liver, which increase the burden of purine metabolism in the body, leading to increased uric acid production.
The results of the China Chronic Disease Prospective Study show that over the past 10 years, the amount of alcohol consumed by men, the frequency of alcohol consumption, and the number of men engaging in intermittent heavy drinking have increased, especially among young men. Alcohol not only increases uric acid production by increasing the turnover rate of adenine nucleotides but also reduces kidney uric acid excretion, raising blood uric acid levels.
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In addition, the intake of fructose-containing beverages during alcohol consumption has significantly increased. While fructose-containing beverages do not contain purines, they can indirectly induce hyperuricemia. The increased consumption of alcohol and fructose-containing beverages may help explain the increased risk of hyperuricemia in young men.
Gout favors the overweight population
The proportion of overweight men far exceeds that of women
Obesity is a major contributing factor to various chronic metabolic diseases. Studies have shown that obesity is associated with an increased risk of hyperuricemia and gout, with the proportion of overweight men significantly higher than that of women.
Body weight has long been considered a key determinant of blood uric acid levels, with overweight or obesity being recognized as risk factors for hyperuricemia. According to a study by Professor Mu Yiming’s team at the General Hospital of the People’s Liberation Army, based on the BMI classification of Chinese individuals, 34.8% are overweight, and 14.1% are obese. Overweight and obesity are more common in men than women, with 41.1% of men classified as overweight compared to 27.7% of women; and 18.2% of men classified as obese compared to 9.4% of women. The high obesity rate in men may also be an important reason for the higher incidence of hyperuricemia in men compared to women.
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In summary, due to differences in hormone secretion and physical constitution, as well as different dietary habits, the incidence of high uric acid levels or gout in men is relatively higher than in women. Both men and women should maintain good dietary habits, control their weight, engage in appropriate exercise to prevent and control the occurrence of hyperuricemia or gout.
