Gout is a metabolic disease that is caused by the high level of uric acid in the blood. Uric acid is a waste product that is produced when the body breaks down purines, which are substances found in certain foods and drinks. Normally, uric acid dissolves in the blood and is excreted from the body through urine. However, in individuals with gout, the body either produces too much uric acid or does not excrete enough of it. As a result, uric acid builds up in the blood, forming urate crystals, which then accumulate in the joints and tissues, leading to the symptoms of gout such as severe pain, swelling, redness, and tenderness in the affected joints.

Options 2, 3, and 4 are not correct answers as they do not accurately represent the cause of gout. Urea is a waste product of protein metabolism, high levels of sugar in the blood are associated with diabetes, and high levels of cholesterol are linked to cardiovascular disease. Therefore, it is important to understand that gout specifically occurs due to elevated levels of uric acid in the blood.