Can Your Gut Microbiota Predict If You Will Get Gout?
May 18, 2016
Gout is on the rise around the world and gut health may be part of the problem. The National Institute of Arthritis and Musculoskeletal and Skin Diseases calls gout one of the most painful forms of arthritis out there and recent statistics show around 8.3 million people in the U.S. have it, that’s about 3.9 percent of the population. While 3.9% may not sound like much, another 21% of the U.S. population has a precursor to the disease called hyperuricemia. This new research suggests that the microbes living in our guts could potentially be used as a screening tool for diagnosing gout through a non-invasive fecal test.
What is Gout?
Gout is a form of inflammatory arthritis caused by a build-up of uric acid in the body. It is associated with what medical professionals call the metabolic syndrome, which is a combination of obesity, insulin resistance, high blood pressure, and blood fat concerns. Gout causes intense pain and swelling in the joints. This is due to sharp crystals that settle in these areas and cut into the tissue like glass shards.
The most commonly affected joint is the big toe, but people with gout might suffer pain in a variety of joints including ankles, knees, wrists, fingers and elbows.
What Causes Gout?
Gout is the result of excess uric acid in the blood. Uric acid is a byproduct of purines, a substance that comes from food. Normal levels of uric acid dissolve in the blood and are eventually excreted through the kidneys and intestines. When there is an excess amount, it builds up and crystallizes.
Gout is a challenge to screen people for and diagnose in its early stages, so often you won’t know you have it until a severe level of pain has already started. Once the inflammation sets in, the doctor can check your blood for elevated levels of uric acid and make a clinical diagnosis, but the testing is not very sensitive so researchers have been eager to find new tools to make early diagnosis easier.
Gut Health and Gout
Excretion is the key to preventing gout. A healthy body will excrete 70 percent of the uric acid through the kidneys. The remaining 30 percent is processed via the intestines. Your intestinal microbiota participate in the metabolism of purine and uric acid, helping eliminate them from the body. Certain bacteria, specifically Lactobacillus and Pseudomonas, aid in the synthesis of enzymes used to degrade the uric acid.
One group of researchers hypothesized that the intestinal microbiota might serve as a tool to help predict the incidents of gout. To test their theory, they did a cross-sectional study using 83 individuals, some known to have gout and others with no signs of it.
They tested the structure of the participant’s intestinal microbiota using a gene sequencing technique to create a functional profile of the microbiome. What they found was an alteration of the gut bacteria in the patients with gout.
What is significant is that a comparison of the gout group and the healthy study participants had very few conventional differences that could tell them apart. There were no significant differences in age, gender or body mass index between the two groups. Their blood uric acid levels were different, though, but not in a consistent way. Some of gout group actually had lower levels of blood uric acid, proving that screening using blood uric acid was not an ideal diagnostic tool. They did find the gut bacteria were different consistently, however. This suggests that it may be possible to classify gout based on the composition of an individual’s intestinal microbiota.
Research in this area will certainly continue, not only in the area of diagnostics, but also exploration into any positive linkage between gout and a balanced microbiota. After all, if gut microbes are altered in gout sufferers, this could mean that a healthy gut provides some level of prevention.
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