Gout is on the increase in New Zealand

doi:10.1136/ard.56.1.22

Annals of the Rheumatic Diseases 1997;56:22-26; doi:10.1136/ard.56.1.22

Ann Rheum Dis 1997;56:22-26 ( January )

Extended reports

Gout is on the increase in New Zealand Patrick Klemp,^b Shelley A Stansfield,^a Benjamin Castle,^a M Clare Robertson^b

^a Queen Elizabeth Hospital, Rotorua, New Zealand , ^b Department of Medicine, University of Otago Medical School, Dunedin, New Zealand

Correspondence to: Dr P Klemp, Department of Medicine, University of Otago Medical School, PO Box 913, Dunedin, New Zealand. e-mail: clare.robertson{at}stonebow.otago.ac.nz

Accepted for publication 15 October 1996

OBJECTIVE $---$ To determine the current prevalence of hyperuricaemia and gout in New Zealand Maori and Europeans for comparison with previousstudies.
METHODS $---$ 342 Maori and 315 European men and women aged 15 years and older were studied by personal interview and a musculoskeletalsystem examination. The 1977 ARA criteria for gout in a surveysetting were used and serum uric acid was determined by a uricasemethod. The data were compared with those of previous New Zealandstudies.
RESULTS $---$ Gout was significantly more common in Maori (6.4%) than Europeans (2.9%) ( $Delta$ = 3.6%, 95% confidence interval 0.4 to 6.8) andin Maori men (13.9%) than in European men (5.8%) ( $Delta$ = 8.1%, 95%CI 1.0 to 15.2). Hyperuricaemia was significantly more commonin Maori men (27.1%) than in European men (9.4%) ( $Delta$ = 17.7%, 95%CI 8.3 to 27.1) and in Maori women (26.6%) than in European women(10.5%) ( $Delta$ = 16.1%, 95% CI 8.5 to 23.7). At least 14% of hyperuricaemicindividuals were receiving diuretics, of whom 78% were women.Comparison with previous studies shows that the prevalence ofgout has increased in both Maori and Europeans, particularly inmen. In Maori men the prevalence of gout has risen from 4.5-10.4%previously to 13.9%, and in European men from 0.7%-2.0% previouslyto 5.8%. Clinical differences included a stronger family history,earlier age at onset, and a higher frequency of tophi and polyarticulargout in Maori than Europeans. Of those with gout, 62% of Maoriand 63% of Europeans were hyperuricaemic on the day surveyed andsix (19.4%) were on diuretics. Treatment of gout was inadequatein mostcases.
CONCLUSIONS $---$ Hyperuricaemia and gout remain common among Maori. Of concern is that the prevalence of gout appears to be on the increase,not only in Maori but also in Europeans in NewZealand.

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