Gout epidemic in French Polynesia

A publication in the “Lancet Global Health” underlines the seriousness of the situation, since gout in French Polynesia affects 15% of the population (around 16 times more than in mainland France).

Direction Tahiti, with Géraldine Zamansky, journalist at the Health Magazine on France 5. The origin of this trip to French Polynesia is not happy, we are not talking about sun, lagoons or fine sand, but about a disease. It’s about gout, which is very present there.

franceinfo: The strong presence of this disease, gout, is often associated with the aristocracy of the 18th century?

Geraldine Zamansky: And yes sorry, no dream postcard today. Rather a very worrying picture, since gout affects 15% of the population in French Polynesia. This is 16 times more than in mainland France. A “epidemic”, according to the title of the investigation published this week, in the Lancet Global Health. Even more serious than suspected by its organizer, Professor Tristan Pascart, head of the rheumatology department at the Catholic Institute of Lille. He had been alerted to the astonishing frequency of this disease during one of his internships in Tahiti. And today, this first investigation allows him to clarify it. Firstly, he immediately told me, there was a genetic cause.

This disease is caused by a gene and not by excess alcohol and food?

And even by several genes. Professor Pascart first introduced me to the one that facilitates the gout process. It is already known to slow down the elimination of uric acid, resulting from the digestion of proteins, in the urine. So this acid remains in the blood in too large quantities. To the point of transforming into small crystals which are generally deposited first in the joints of the toes.

And at times, we don’t always know why, these crystals trigger very painful inflammation. This is the famous gout attack. Then a second culprit appears in Polynesia, discovered by Professor Pascart’s team: a gene which will precisely facilitate this inflammation.

And these genes are very present among the population of these islands?

Exactly. This investigation clarifies their involvement thanks to the 874 participants who took multiple exams and recounted their lifestyle. Results: those who have gout also often suffer from diabetes and obesity, but which are also partly caused by their genetic particularities for Professor Pascart. Because they do not eat or drink more than the “control” group, without gout.

The problem is that, there too, this disease remains associated, as you said, with excess alcohol and food. In this climate of guilt, only 1 in 3 affected people are correctly treated, even though there is a very effective medication: allopurinol.

However, the stakes are high: a gout attack increases the risk of having a stroke or heart attack. Professor Pascart hopes that this exposure of a serious public health problem will improve its management.

The study