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Cause
High levels of uric acid in the blood (hyperuricemia) is the underlying cause of gout. This can occur for a number of reasons, including diet, genetic predisposition, or underexcretion of urate, the salts of uric acid.[2] Renal underexcretion of uric acid is the primary cause of hyperuricemia in about 90% of cases, while overproduction is the cause in less than 10%.[6] About 10% of people with hyperuricemia develop gout at some point in their lifetimes.[7] The risk, however, varies depending on the degree of hyperuricemia. When levels are between 415 and 530 μmol/l (7 and 8.9 mg/dl), the risk is 0.5% per year, while in those with a level greater than 535 μmol/l (9 mg/dL), the risk is 4.5% per year.[1]
Lifestyle
Dietary causes account for about 12% of gout,[2] and include a strong association with the consumption of alcohol, fructose-sweetened drinks, meat, and seafood.[4][8] Other triggers include physical trauma and surgery.[6] Recent studies have found that other dietary factors once believed associated are, in fact, not, including the intake of purine-rich vegetables (e.g., beans, peas, lentils, and spinach) and total protein.[9][10] With respect to risks related to alcohol, beer and spirits appear to have a greater risk than wine.[11]
The consumption of coffee, vitamin C and dairy products, as well as physical fitness, appear to decrease the risk.[12][13][14] This is believed partly due to their effect in reducing insulin resistance.[14]