Gibson T, Waterworth R, Hatfield P, Robinson G, Bremner K
Br J Rheumatol. 1984 Nov;23(4):276-82. doi: 10.1093/rheumatology/23.4.276.
Several previous studies have demonstrated an increased prevalence of gout in New Zealand Maoris. The aetiology of the hyperuricaemia and its effect on morbidity, apart from gout, are unknown. A survey of 115 Maori men of working age revealed a history of gout in 10 (8%) and asymptomatic hyperuricaemia in 26 (23%). The relationship of hyperuricaemia with obesity was confirmed. Alcohol did not make an obvious contribution to the prevalence of hyperuricaemia. Hypertension was more common and creatinine clearance lower amongst those with gout, but not significantly so. The frequency of hypertension and mean creatinine clearance were similar to that seen in asymptomatic hyperuricaemia and normouricaemia. Urate clearance was lower in the gouty and hyperuricaemic subjects. The normouricaemic Maoris had a reduced fractional urate clearance compared with normal men elsewhere. They also excreted a relatively small proportion of hydrogen as ammonium. Both these features are characteristic of gout, and suggest that the Maoris' susceptibility to hyperuricaemia has a renal mechanism. Obesity is common amongst the Maoris and accentuates their natural tendency to hyperuricaemia.
此前的多项研究表明,新西兰毛利人中痛风的患病率有所上升。除痛风外,高尿酸血症的病因及其对发病率的影响尚不清楚。一项针对115名工作年龄毛利男性的调查显示,10人(8%)有痛风病史,26人(23%)有无症状高尿酸血症。高尿酸血症与肥胖之间的关系得到了证实。酒精对高尿酸血症患病率的影响并不明显。痛风患者中高血压更为常见,肌酐清除率较低,但差异不显著。高血压的发生率和平均肌酐清除率与无症状高尿酸血症和尿酸正常者相似。痛风患者和高尿酸血症患者的尿酸清除率较低。与其他地方的正常男性相比,尿酸正常的毛利人的尿酸清除率分数降低。他们以铵的形式排出的氢离子比例也相对较小。这两个特征都是痛风的特点,表明毛利人对高尿酸血症的易感性有肾脏机制。肥胖在毛利人中很常见,加剧了他们高尿酸血症的自然倾向。