In Aoteoroa / New Zealand 6% of Māori, 8% of Pacific and 3% of European people have the arthritis gout and there is co-morbidity with other serious diseases, such as diabetes, heart and kidney disease. Gout is caused by an immune response to urate crystals when urate levels are elevated. Here we will use our existing large genome-wide genotyped datasets, and various genetic epidemiological approaches, to address four clinically-relevant and translatable questions. Do environmental exposures impact differently on the risk of gout according to genotype? Does gout cause co-morbidities? Can response to the common gout drug allopurinol be predicted more accurately? What is the relative contribution of diet, allopurinol, genetics to urate levels in people with gout? Outcomes will be: more specific lifestyle advice and drug prescribing for people with gout (precision medicine); data that may support more intensive treatment to prevent co-morbidities.