Gout risk tied to alcohol intake (but not wine)

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Rheumawire

Apr 19, 2004

Gout risk tied to alcohol intake (but not wine)

Boston, MA - Alcohol intake is strongly associated with increased

risk of gout, but the risk varies with the type of alcoholic beverage,

Dr Hyon K Choi (Harvard Medical School, Boston, MA) and colleagues

report in the April 17, 2004 issue of the Lancet [1].

" eer increased the risk of gout per serving per day more than

twice as much as did spirits (49% and 15%, respectively, even though

alcohol content per serving was less for beer than spirits (12.8 g vs

14.0 g, respectively). Further, wine consumption of two 4-oz glasses or

more per day was not associated with an increased risk of gout. These

findings suggest that certain nonalcoholic components that vary across

these alcoholic beverages play an important role in the incidence of

gout, " Choi et al write.

Choi and colleagues analyzed 730 confirmed incident cases of gout

in the Health Professionals Follow-up Study, an ongoing longitudinal

study of 51 529 male healthcare professionals. Subjects completed

biennial questionnaires over 12 years (1986-1998) about diet, medical

history, and medications.

Diet histories used standard portions: a 12-oz (355-mL) bottle or

can of beer, a 4-oz (118-mL) glass of wine, and a shot of spirits (44

mL). The investigators determined alcohol consumption by multiplying the

consumption of each beverage by its ethanol content: beer 12.8 g, light

beer 11.3 g, wine 11.0 g, and spirits 14.0 g. Daily ethanol intake was

then categorized into 7 categories: none; 0.1 to 4.9 g; 5.0 to 9.9 g;

10.0 to 14.9 g; 15.0 to 29.9 g; 30.0 to 49.9 g; and 50.0 g or more.

Frequency of intake was categorized as less than 1 per month, 1 per

month to 1 per week, 2 to 4 per week, 5 per week to 1 per day, and 2 or

more per day. Multivariate models were adjusted for age; total energy

intake; body-mass index; use of diuretics; history of hypertension;

history of chronic renal failure; and daily average intake of meats,

seafood, purine-rich vegetables, dairy foods, and fluids.

Gout relative risk (RR) increased by 1.15 for each additional 10-g

daily ethanol intake. Relative risk increased from 1.3 at 5.0 to 9.9

g/day to 3.02 for >50 g/day (p<0.0001).

There was no significant relationship between body-mass index and

risk of gout.

Compared with men who did not drink beer, the relative risk of

gout was 1.27 for men who drank 2 to 4 servings of beer per week,

increasing to 2.51 for men who drank 2 or more servings of beer per day

(p<0.0001). The multivariate RR for each additional serving of beer per

day was 1.49.

" Beer is the only alcoholic beverage acknowledged to have a large

purine content, " Choi says. " Thus, the effect of ingested purine in beer

on uric acid in blood might be sufficient to augment the hyperuricemic

effect of alcohol itself, producing a greater risk of gout than spirits

or wine. Whether there might be other nonalcoholic risk factors in beer

or protective factors in wine remains unknown. "

Compared with men who did not drink spirits, the relative risk of

gout was 1.27 for men who had 1 drink per month to 1 per week, and RR

was 1.6 for men who had 2 or more servings of spirits per day. The RR

for each additional serving of spirits per day was 1.15.

By contrast, men who drank 2 or more glasses of wine per day had

no increased risk of gout compared with those who drank less than 1

glass per month, and there was no significant increase in gout at higher

levels of wine consumption. This held true for both red wine and white

wine.

" The risk of gout was significantly raised with alcohol intake as

low as 10.0 g to 14.9 g/day, and the magnitude of the association rose

with increasing intake. The risk of gout was 2.5 times higher among men

who consumed 50 g or more of alcohol per day compared with those who

abstained from alcohol. These associations were independent of dietary

and other purported risk factors of gout such as body-mass index, age,

hypertension, use of diuretics, and chronic renal failure, " Choi

concludes.

Janis

Source

1. Choi HK, Atkinson K, Karlson EW, et al. Alcohol intake and risk

of incident gout in men: a prospective study. Lancet 2004;

363:1277-1281.

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org