Stool analysis, a better approach for gout diagnosis?
The problem
Almost all clinical diagnosis of gout requires performing blood tests for blood uric acid concentration. However recent studies suggests that the blood ucic acid index is not sufficiently sensitive. This is because individuals suffered from gout are frequently in a stressed state, which causes reflective secretion of adrenocorticotrophic hormone to compel the discharge of uric acid by kidney. Consequently, there can be no significant rise of uric acid for most early-onset gout patients.
Gout and poo?
Healthy humans excrete uric acid in two main ways, with 70% excreted through the kidney and the remaining 30% via the intestine. Human intestine homes a huge number of microbes collectively known as intestinal microbiota, whose activities are linked to numerous host functions. The intestinal microbiota are known to participate in metabolism of purine and uric acid. Therefore, it is hypothesized that the intestinal microbiota can potentially serve as proxy to probe uric acid metabolism in the host for the purpose of diagnosis or prognosis.
Test group results
A recent study published on scientific reports on 08 February 2016 based on a group of 83 Chinese adults found that intestinal microbiota of gout patients are highly distinct from healthy individuals.
a diagnosis model for gout based on metagenomic genera of intestinal microbiota sampled from stool has shown promise in improving the sensitivity of diagnosis, where the model based on 17 genera achieved 88.9% accuracy
In fact, patients in the validation group that could not be reliably diagnosed by blood uric acid value can be correctly diagnosed as gout using the microbial index.
For those of you who don’t like getting poked by a needle, it just might be a matter of time before they take your stool samples.
References Guo, Z. et al. Intestinal Microbiota Distinguish Gout Patients from Healthy Humans. Sci. Rep. 6, 20602; doi: 10.1038/srep20602 (2016). http://www.nature.com/articles/srep20602
