Puig J G, Michán A D, Jiménez M L, Pérez de Ayala C, Mateos F A, Capitán C F, de Miguel E, Gijón J B
Division of Internal Medicine, La Paz University Hospital, Madrid, Spain.
Arch Intern Med. 1991 Apr;151(4):726-32. doi: 10.1001/archinte.151.4.726.
We reviewed the clinical features and uric acid metabolism in 37 female patients with gout. In 32 female patients (86%), gout was diagnosed after menopause. Among the five premenopausal patients, four had renal insufficiency and one had superactivity of phosphoribosylpyrophosphate synthetase. More than 50% of the female patients had osteoarthritis, hypertension, or renal insufficiency or were treated with diuretics. Comparison with 220 male patients with gout showed that female patients developed gout significantly later, more frequently had associated diseases, and more often were receiving diuretics, whereas significantly more male than female patients had alcoholism. The articular features of gout were similar in both groups. However, the prevalence of tophi was higher and its localization different in female than in male patients. Female patients with gout had a higher mean serum urate concentration and a lower mean urinary uric acid excretion than did male patients with gout. These differences were significant and independent of the effects of age, renal insufficiency, alcoholism, or previous diuretic intake. Renal underexcretion of uric acid appears to be more severe in female than in male patients with gout.
我们回顾了37例女性痛风患者的临床特征及尿酸代谢情况。32例（86%）女性患者痛风在绝经后被诊断。在5例绝经前患者中，4例有肾功能不全，1例有磷酸核糖焦磷酸合成酶活性过高。超过50%的女性患者有骨关节炎、高血压或肾功能不全，或正在接受利尿剂治疗。与220例男性痛风患者比较显示，女性患者痛风发病明显较晚，合并疾病更常见，且更常接受利尿剂治疗，而男性痛风患者患酒精中毒的明显多于女性。两组痛风的关节特征相似。然而，女性患者痛风石的患病率更高，其部位与男性患者不同。女性痛风患者的平均血清尿酸盐浓度高于男性痛风患者，而平均尿尿酸排泄低于男性痛风患者。这些差异具有显著性，且独立于年龄、肾功能不全、酒精中毒或既往利尿剂使用的影响。痛风女性患者尿酸肾脏排泄不足似乎比男性患者更严重。
