Gout prevalence in the Hmong: a prime example of health disparity and the role of community-based genetic research

Per Med. 2021 May;18(3):311-327. doi: 10.2217/pme-2020-0107. Epub 2021 Mar 31.

Abstract

Individuals of distinct Asian backgrounds are commonly aggregated as Asian, which could mask the differences in the etiology and prevalence of health conditions in the different Asian subgroups. The Hmong are a growing Asian subgroup in the United States with a higher prevalence of gout and gout-related comorbidities than non-Hmong. Genetic explorations in the Hmong suggest a higher prevalence of genetic polymorphisms associated with an increased risk of hyperuricemia and gout. History of immigration, acculturation, lifestyle factors, including dietary and social behavioral patterns, and the use of traditional medicines in the Hmong community may also increase the risk of developing gout and lead to poor gout management outcomes. Engaging minorities such as the Hmong population in biomedical research is a needed step to reduce the burden of health disparities within their respective communities, increase diversity in genomic studies, and accelerate the adoption of precision medicine to clinical practice.

Keywords: Asian subgroups; Hmong; community-based genetic research; community-based participatory research; ethnicity; genetics; gout; health disparities; hyperuricemia; racial minorities.

Plain language summary

People of different Asian heritage are commonly grouped as Asian, which could mask the differences in the causes and rates of specific health conditions in the different Asian subgroups. The Hmong are a growing Asian group in the United States with higher gout rates and gout-related conditions than non-Hmong. Genetic research in the Hmong suggests higher rates of genetic changes associated with higher urate levels and increased gout risk. The immigration to the United States and adaptation to the Western lifestyle could also affect the Hmong's risk for developing elevated urate levels and gout. Some lifestyle factors, including dietary and social behavioral patterns, and the use of traditional medicines in the Hmong, may also increase their risk of developing gout and lead to poor gout management. Engaging minorities such as the Hmong population in clinical research is a needed step to reduce the burden of health disparities within their respective communities, increase diversity in genetic studies, and widen the application of precision medicine to clinical practice.

Publication types

  • Review

MeSH terms

  • Age of Onset
  • Aged
  • Asian*
  • Chronic Disease
  • Community-Based Participatory Research / organization & administration*
  • Ethnicity*
  • Female
  • Genetic Research
  • Gout / ethnology*
  • Gout / genetics
  • Health Behavior
  • Health Status Disparities
  • Health Surveys
  • Humans
  • Hyperuricemia / ethnology*
  • Hyperuricemia / genetics
  • Life Style
  • Male
  • Middle Aged
  • Minnesota / epidemiology