NEW ZEALAND – Scientists have revealed gene variants that could help explain why Maori and Pacific people have the highest rates of gout in the world.

Advances in genetic research into gout underline Arthritis New Zealand’s message to people living with this extremely painful disease.

Gout causes excruciating pain and swelling in the joints of the hands and feet, usually the big toes.

It’s the result of high levels of uric acid in the blood and can lead to long term joint damage and disability if left untreated.

Men of Maori and Pacific island descent are the most affected. Six per cent of Maori and eight per cent of Pacific people in New Zealand live with the condition.

In a world first, an international research team led by the University of Otago scoured DNA data to identify gene variants associated with the risk of gout in Maori and Pacific people.

They discovered that changes to the ABCC4 gene means the kidneys are less able to flush uric acid from the blood and out of the body. Another gene variant plays a role in the condition in Maori and Pacific people but not those with European ancestry.

Sandra Kirby, Chief Executive of Arthritis New Zealand, said the findings reinforce the message that gout is mostly to do with genes, not diet.

“Gout is the second most common form of arthritis in New Zealand, and many people think they get attacks because they drink too much beer, or eat too much seafood.

“While certain foods trigger attacks in some people, diet is only part of the reason for high uric acid levels. Mostly, it’s a genetic condition, as this research now shows.”

Arthritis New Zealand works to educate people about gout.

“Gout is a no joke, no fault disease, and we have to take it seriously. The good news is that effective treatment is available, not just to manage attacks, but to prevent them occurring. We encourage people to see their doctor or pharmacist and get treatment,” Kirby said.

The study, which appears in the international journal Arthritis and Rheumatology, also highlighted the importance of looking at what drugs may benefit different populations through taking genetic variations into account.

“Our research is the first to specifically look at gout-related genetic variations in Maori and Pacific people,” said study leader Professor Tony Merriman, of the University of Otago Department of Biochemistry.

“In terms of medical research into drug treatments, people of European heritage are arguably the most studied in the world, but such findings may not necessarily apply neatly to other groups.

“In the case of some Maori and Pacific people their genetic make-up likely causes them to be more susceptible by having inherently higher levels of uric acid - probably a beneficial characteristic, aside from causing gout of course.”

In the wake of the new findings, Merriman said more research was warranted, including exploring using existing medications that may specifically target the gene the team has identified.

“While the commonly prescribed medication allopurinol will likely remain the most widely used treatment for reducing uric acid levels in gout, there is an enormous opportunity to screen for drugs that might be even more effective in treating the condition in Maori and Pacific people and other non-European groups.

“It is important that we broaden our approach to identifying what therapies might be most effective with different groups.”

- Gout is the second most common form of arthritis in New Zealand.

- About 162,000 New Zealanders aged 20 and over have gout. (2014 figures, up from around 136,000 in 2012.)

- Men, Māori and Pacific people are most affected.

- Gout causes painful swelling of joints, especially toes, knees, elbows, wrists and fingers.

- Many people inherit gout from parents or grandparents.

- Gout is caused by too much uric acid in the blood.

- Gout is not cured even when the pain goes away.

- Left untreated, gout can lead to long term joint damage and disability.

- Preventative medication, good food, water, and exercise are the keys to controlling gout. - Scoop/PNC