The hyperuricaemia associated with gout is believed to be due to overproduction of uric acid, to impaired renal excretion of uric acid, or to alterations in both mechanisms (Seegmiller, 1966). In all likelihood, gout encompasses a heterogeneity of biochemical disorders, the metabolic or enzymatic bases of which with one exception, have not yet been completely delineated. The Lesch-Nyhan syndrom...

This invited paper provides a summary of a keynote lecture delivered at the 2011 Australasian Podiatry Conference. Gout is the most prevalent inflammatory arthropathy. It displays a striking predilection to affect the first metatarsophalangeal joint as well as joints within the mid-foot and ankle. A number of factors are known to reduce urate solubility and enhance nucleation of monosodium urat...

Based on the clinical observation that patients with right or left heart failure often present with hyperuricaemia, the relation between serum urate values and haemodynamic variables was studied in patients with primary pulmonary hypertension (PPH) as well as in patients with advanced ischaemic heart disease or dilated cardiomyopathy. The study was a retrospective analysis of 39 patients with P...

INTRODUCTION Hyperuricemia is the greatest risk factor for gout and is caused by an overproduction and/or inefficient renal clearance of urate. The fractional renal clearance of urate (FCU, renal clearance of urate/renal clearance of creatinine) has been proposed as a tool to identify subjects who manifest inefficient clearance of urate. The aim of the present studies was to validate the measur...

INTRODUCTION Gout is the most common inflammatory arthritis in men over 40 years of age. Long-term urate-lowering therapy is considered a key strategy for effective gout management. The primary outcome measure for efficacy in clinical trials of urate-lowering therapy is serum urate levels, effectively acting as a surrogate for patient-centred outcomes such as frequency of gout attacks or pain. ...

OBJECTIVES To evaluate the person-level impact of weight loss on serum urate levels among men with a high cardiovascular risk profile. METHODS We analysed 12,379 men (mean serum urate level=407 μmol/l) from the Multiple Risk Factor Intervention Trial, using data prospectively collected at baseline and annually over a 7-year period (78,881 visits). Our endpoint was normouricaemia, defined by s...

A direct ultraviolet absorption method that does not require uricase for the determination of serum urate is presented. Serum (0.3 ml.) is placed in the bottom of a 25 X 95-mm. shell vial and coagulated by immersion of the vial in boiling water for 2 mm. The clot is overlaid with 3.0 ml. of water and the serum urate extracted for 60 mm. at 37#{176}. The absorbance of the extract is measured at ...

During routine biochemical screening of over 4,000 patients admitted to the Veterans Administration Wadsworth Hospital Center, a small number were found to have serum urate concentrations below 2-2 mg/100 ml. Most of these patients had profound illness, including severe hepatic involvement with jaundice. It is known that circulating bilirubin is highly bound to proteins (Odell, 1959). Previous ...

Gout is the most common inflammatory arthritis characterized by painful disabling acute attacks. It is caused by hyperuricemia and deposition of urate crystals in and around the joints. Long-standing untreated hyperuricemia can lead to chronic arthritis with joint damage, tophi formation and urate nephropathy. Gout is associated with significant morbidity and health care associated cost. The go...

Higher plasma urate concentration has been linked to lower risk of Parkinson's disease in men, but data are lacking on women and African Americans. The authors examined plasma urate in relation to Parkinson's disease in the biracial, population-based Atherosclerosis Risk in Communities (ARIC) cohort. Between 1987 and 1989, 15,792 participants, aged 45-64 years, were recruited from 4 US communit...