Rheumatology International

, Volume 34, Issue 6, pp 743–757

Hyperuricaemia in the Pacific: why the elevated serum urate levels?

  • Anna L. Gosling
  • Elizabeth Matisoo-Smith
  • Tony R. Merriman
Review

DOI: 10.1007/s00296-013-2922-x

Cite this article as:
Gosling, A.L., Matisoo-Smith, E. & Merriman, T.R. Rheumatol Int (2014) 34: 743. doi:10.1007/s00296-013-2922-x

Abstract

Pacific Island populations, particularly those of Polynesian descent, have a high prevalence of hyperuricaemia and gout. This is due to an inherently higher urate level among these populations with a demonstrated genetic predisposition. While an excess of urate can cause pathology, urate is also important for human health. It has been implicated as an antioxidant, has a neuroprotective role and is involved in innate immune responses. This paper provides a brief review of urate levels worldwide, with a particular focus on island Southeast Asia and the Pacific. We then present possible evolutionary explanations for the elevated serum urate levels among Pacific populations in the context of the physiological importance of urate and of the settlement history of the region. Finally, we propose that ancestry may play a significant role in hyperuricaemia in these populations and that exposure to malaria prior to population expansion into the wider Pacific may have driven genetic selection for variants contributing to high serum urate.

Keywords

HyperuricaemiaSerum uratePacific IslandersMigrationSelectionMalaria

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Anna L. Gosling
    • 1
    • 2
  • Elizabeth Matisoo-Smith
    • 1
  • Tony R. Merriman
    • 2
  1. 1.Department of Anatomy, Allan Wilson Centre for Molecular Ecology and EvolutionUniversity of OtagoDunedinNew Zealand
  2. 2.Department of BiochemistryUniversity of OtagoDunedinNew Zealand