ESR1 and gout: Interestingly, three genes (PDZK1, GCKR and HNF4G) associated with urate influenced the risk of gout, but the other five genes (TCF7L2, LRRC16A, ESR1, NRXN2 and ALPK1) did not, suggesting that elevated serum urate concentration is necessary but not sufficient for the pathogenesis of gout (Fig. 3).