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Consumption of Beer and Spirits Strongly Associated With Increased Risk of Gout in Men
Lancet
04/15/2004
By Joene Hendry
Men who consume beer and spirits, especially in large amounts, are at increased risk of developing gout; but this risk is not increased with moderate consumption of wine.
"Our findings are most generalisable to men aged 40 years and older (the most gout-prevalent population) with no history of gout," write Hyon K. Choi, MD, Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States, and colleagues.
Using data from the ongoing, longitudinal Health Professionals Follow-up Study, the researchers assessed alcohol consumption and the incidence of gout through responses to biennial questionnaires from 47,150 men with no history of gout at baseline. Alcohol intake was calculated using the content of 12 oz beer at 12.8 g ethanol, of 4 oz wine at 11.0 g of ethanol, and a shot of spirits measuring 44 mL at 14.0 g of ethanol.
Over 12 years, the study population experienced 730 newly diagnosed cases of gout that met American College of Rheumatology criteria. The age adjusted relative risk of gout was 1.13 for daily alcohol intake of 0.1-4.9 g and sequentially rose to 3.02 for daily intake at or more than 50 g, compared with men reporting no alcohol consumption.
Similar analysis that adjusted for age, total energy intake, body mass index, diuretic use, history of hypertension, history of renal failure, intake of total meats, seafood, purine-rich vegetables, dairy foods and fluids, showed that the relative risk of gout was 1.09 for daily alcohol intake of 0.1-4.9 g and sequentially increased to 2.53 for daily intake at or over 50 g, compared with no alcohol intake.
Multivariate analysis according to the type of alcoholic beverage, compared with less than 1 serving per month, showed the relative risk of developing gout was 1.01 for 1 beer per month to 1 beer per week and increased sequentially to 2.51 for more than 2 beers per day. Corresponding relative risks for spirits ranged from 1.27 for 1 serving per month to 1 per week to 1.60 for more than 2 servings per day. Conversely, the relative risks for wine consumption ranged from 0.84 for 1 serving per month to 1 per week to 1.05 for more than 2 servings per day.
The authors conclude that their prospective study shows "that alcohol intake is strongly associated with an increased risk of gout [in men]."
"Given the potential effect of female hormones on the risk of gout in women and an increased role of high purine intake on uric acid levels among patients with existing gout, prospective studies of these populations are necessary," they note.
Lancet 2004;363:1277-81.
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