GOUT AND SERUM URIC ACID LEVELS IN THE COTSWOLDS

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Abstract
A Cotswold population has been studied to investigate the prevalence of gout and its relation to the distribution of serum uric acid (SUA) levels. In the survey 3892 respondents aged 35 years and over were seen, a completion rate of 85 %. 147 of the 3872 respondents for whom information on rheumatic complaints was available reported gout, a frequency of 3.8 %. The condition could be established in only 35 of these, yielding an overall prevalence of gout of 0.93%. This is somewhat higher than has been reported previously, but various factors make it difficult to say whether this is a true impression and the prevalence may be of the same order as had been found in U.S.A. studies. The mean of the distribution of SUA levels is of the same order as that reported from other Caucasian populations. Various possible environmental factors which might contribute to the higher prevalence of gout in the Cotswolds were investigated, such as source of the water supply, social class, and length of residence in the area, but none was found to be associated. Gout was more frequent in locally born respondents, but consideration of place of birth of the respondents′ parents failed to support the idea that high prevalence might be an hereditary characteristic of the indigenous population. An excess of respondents were currently taking diuretics of the thiazide type, but how much these drugs contributed to the development of gout is uncertain. An excess of gouty respondents were taking medication for coronary heart disease.

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