Elsevier

The American Journal of Medicine

Volume 119, Issue 9, September 2006, Pages 800.e11-800.e16
The American Journal of Medicine

AJM online
Clinical research study
Alcohol Consumption as a Trigger of Recurrent Gout Attacks

https://doi.org/10.1016/j.amjmed.2006.01.020Get rights and content

Abstract

Background

Alcohol consumption has long been considered a trigger for recurrent gout attacks; however, this hypothesis has not been formally tested.

Methods

We conducted an Internet-based case-crossover study to assess several putative risk factors, including alcohol consumption, thought to trigger recurrent gout attacks. Subjects who had an attack within the past year were recruited online and asked to provide access to medical records pertaining to their gout. Data were obtained on the amount and type of alcoholic beverage consumed on each day over the 2-day period before a gout attack and on each day over a 2-day period during the intercritical period. We examined the amount and type of alcohol consumption and the risk of recurrent gout attacks using a conditional logistic regression adjusting for diuretic use and purine intake.

Results

A total of 197 subjects were recruited online over a 10-month period. Of those, 179 (91%) fulfilled the American College of Rheumatology Criteria for gout. Compared with no alcohol consumption, odds ratios for recurrent gout attacks were 1.1, 0.9, 2.0, and 2.5 for 1 to 2, 3 to 4, 5 to 6, and 7 or more drinks consumed over the 2-day period, respectively (P<.005). A dose-response relationship of risk of gout attacks was more evident for alcohol consumed over the last 24 hours. An increased risk of recurrent gout attacks was found for each type of beverage consumed.

Conclusion

Alcohol consumption triggers recurrent gout attacks. This effect was likely to occur within 24 hours after its consumption.

Section snippets

Methods

We constructed a website for this study (https://dcc2.bumc.bu.edu/GOUT) on an independent secure server within the Boston University Medical Center domain. The study website provided information about the study, invited applicants to participate, administered a screening questionnaire, linked eligible respondents to an online consent form, and administered additional questionnaires to assess risk factors and features of respondents’ recurrent gout attacks.

The study was advertised on the Google

Statistical analysis

Total alcohol consumption (grams) for each day and over the 2-day period was calculated by multiplying the average alcohol content in beer, wine, and spirits times the number of drinks consumed over the specified period. The total alcohol intake per day (in grams) was estimated as ([0.57 × the number of cocktails per day] + [0.44 × the number of bottle or cans of beers per day] + [0.40 × the number of glasses of wine per day]) × 28.35. This latter term represents 28.35 g of alcohol per fluid

Results

Of 197 subjects who completed both Hazard-period and Control-period Questionnaires, 179 subjects (91%) fulfilled the ACR Criteria for gout.27 Gout diagnosis was confirmed by the presence of the crystal in only 37 subjects (19%). A total of 186 subjects (94.4%) returned a signed Medical Record Release Form. Of those, we obtained 172 subjects’ medical records or physician’s checklists from their physicians, and 164 (95.3%) met ACR Criteria for gout.27

The characteristics of the participants are

Discussion

Although alcohol has long been considered a risk factor triggering recurrent gout attacks, to our knowledge, this is the first study that has formally tested this hypothesis. Our results suggest that alcohol intake, irrespective of the type of beverage consumed, was associated with an increased risk of recurrent gout attacks. The effect-period of alcohol was short, likely to occur within the first 24 hours after alcohol consumption.

Although many studies have found that alcohol consumption

Conclusion

The present study found that alcohol intake, even a light-to-moderate amount, triggers recurrent gout attacks. We suggest that subjects with established gout avoid drinking alcohol to lower their risk of recurrent gout attacks.

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  • Cited by (0)

    Supported by an Arthritis Foundation Clinical Science Grant, a grant from the Department of Medicine, Boston University School of Medicine, National Institutes of Health AR47785, and by TAP Pharmaceutical Co.

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