People’s standard of living is getting better and better, and with it more and more affluent diseases. Not to mention those high blood pressure, diabetes, coronary heart disease, as a rheumatologist, let’s talk about gout today. I see 20 to 30 patients in each clinic, there are always one or two gout. When the name is called in the whistler, a middle-aged male grimacing in his forties or fifties, or a young man in his twenties or thirties, on the fat side (of course, there are a few thin ones) limps in. Before I could sit down, I asked, “Gout, right? Most of the time you can guess right. Yes, gout is a “rich disease” that loves to find such people. We used to say that the high incidence of gout was among obese middle-aged men. Nowadays, there are more and more young guys and skinny guys. Therefore, the cause of gout is not entirely diet, obesity, there may also be lifestyle problems, such as not loving exercise, stay up late for a long time and so on. Gout, of course, the most direct cause is elevated uric acid. However, not all people with hyperuricemia will get gout. The high level of uric acid, coupled with a number of triggers, can easily attack gout. How high is it? This varies from person to person, but generally speaking, the chance of gout is higher at 500 umol/L or more. So what triggers can trigger gout? A common one is a high purine diet. For example, if you eat a meal of shabu-shabu or seafood and drink a few beers, you will easily have a gout attack. Some people may say, “I didn’t eat anything special before I had the attack! Yes, not all gout is caused by diet. Sometimes gout can be triggered by exercise, minor injuries, and cold. For example, if you play a game of football and break your foot gently, or if you accidentally put your foot out of the blanket in winter, etc. Therefore, the higher the uric acid, the more likely you are to have a gout attack. If the uric acid is very high, for example, to 600umol/L or higher, a little wind may cause a gout attack.