When compared with patients without gout or those with gout but in the intercritical period, patients with gout flare have significantly higher median levels of cadmium and lead in both the blood and urine, indicating that the risk of gout flare status is associated with increased cadmium levels and that blood and urine levels of cadmium are a risk factor for gout flare status, according to a study published in Chemosphere. With evidence that cadmium and lead are toxic heavy metals with endocrine-disrupting properties, investigators assessed the associations between low-level environmental exposure to both and gout status (intercritical gout, gout flare, combined gout) by measuring levels of both in blood and urine samples of patients recruited from a gout clinic. Median blood levels for cadmium and lead were 0.87 μg/L and 31.54 μg/L, respectively, in the gout flare group, while median urine levels were 1.05 μg/L and 3.86 μg/L, respectively, all significantly higher than levels observed in the control or intercritical groups. When compared with tertile 1, tertile 2 for cadmium blood level and tertile 3 for cadmium urine level were significantly associated with gout flare status. For lead urine levels, risk of gout flare status was significantly higher in tertile 2 when compared with tertile 1.