<prompt> All of the following statements about primary Gouty ahritisare true, Except90 of cases are caused by over production of uric acidUric acid levels may be normal at the time of an acute attackMen are more commonly affected than women Male FemalesDefinitive diagnosis requires aspiration of synol fluid  <response>: In over 90 of patients, the main abnormality is reduced uric acidexcretion by the kidney, which is genetically determined. Impaired renal excretion of urate also accounts for the occurrence of hyperuricaemia in chronic renal failure, and for hyperuricaemia associated with thiazide diuretic therapy . The prevalence of gout is approximately 1-2, with a greater than 5 : 1 male preponderance. Gout has become progressively more common over recent years in affluent societies due to the increased prevalence of obesity and metabolic syndrome . Ref Davidsons 23e p1013 