How do Age and Gender Influence the Incidence of Gout? (Commonly observed in middle-aged and elderly males; incidence increases in females after menopause)
Let's put it this way: you can imagine the uric acid in our bodies as water in a pool, and our kidneys as the drainpipe. A gout attack is like the pool overflowing.
Why are middle-aged and elderly men more susceptible?
For men, starting from puberty, male hormones make the kidneys' "drainpipe" slightly narrower, leading to less efficient drainage compared to women. Consequently, men naturally have higher uric acid levels in their blood than women.
Accumulating over time, year after year, the water level in this "pool" remains relatively high. While the body can cope in youth, after middle age, metabolism slows down. Coupled with factors like drinking alcohol or eating seafood, which "turn on the faucet" more, the water easily overflows, leading to a gout attack. Because this process builds up over many years, it is more common in middle-aged and elderly men.
Why does the incidence rate also increase for women after menopause?
Before menopause, women have estrogen, a "secret weapon" in their bodies. Estrogen helps the kidneys' "drainpipe" function more smoothly, accelerating the excretion of uric acid. Therefore, their "pool" water level consistently stays at a low, safe position, making them naturally less prone to gout.
However, once women reach menopause, estrogen levels drop sharply. With this "secret weapon" gone, the efficiency of the "drainpipe" also declines, becoming similar to that of men. The body then starts to accumulate uric acid more easily, just like men.
Consequently, their "pool" water level gradually rises, and the risk of developing gout naturally increases significantly. This is why the incidence rate for women typically starts to catch up only after menopause.
In summary:
- Men: Naturally have slower "drainage," so their risk is consistently higher, and they are prone to "overflow" in middle and old age.
- Women: In youth, estrogen helps with "drainage," keeping the risk low; after menopause, this help disappears, and the risk increases.