Alcohol quantity and type on risk of recurrent gout attacks: An internet-based case-crossover study

Alcohol quantity and type on risk of recurrent gout attacks: An internet-based case-crossover study

• Tuhina Neogi, MD, PhD (Associate Professor of Medicine and of Epidemiology)
, 
• Clara Chen, MHS (Assistant Director, Operations)
, 
• Jingbo Niu, DSc (Research Assistant Professor of Medicine)
, 
• Christine Chaisson, MPH (Research Assistant Professor)
, 
• David J. Hunter, MD (Professor of Medicine)
, 
• Yuqing Zhang, DSc (Professor of Medicine and of Epidemiology)

Received 20 September 2013; received in revised form 23 December 2013; accepted 26 December 2013. published online 21 January 2014.
Accepted Manuscript

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Abstract 

Objectives

Although beer and liquor have been associated with risk of incident gout, wine has not. Yet anecdotally, wine is thought to trigger gout attacks. Further, how much alcohol intake is needed to increase the risk of gout attack is not known. We examined the quantity and type of alcohol consumed on risk of recurrent gout attacks.

Methods

We conducted a prospective internet-based case-crossover study in the United States among participants with gout and who had at least one attack during the one year of follow-up. We evaluated the association of alcohol intake over the prior 24 hours as well as the type of alcoholic beverage with risk of recurrent gout attack, adjusting for potential time-varying confounders.

Results

This study included 724 participants with gout (78% men, mean age 54 years). There was a significant dose-response relationship between amount of alcohol consumption and risk of recurrent gout attacks (p<0.001 for trend). The risk of recurrent gout attack was 1.36 (95% CI: 1.00 to 1.88) and 1.51 (95% CI: 1.09 to 2.09) times higher for > 1-2 and > 2-4 alcoholic beverages, respectively, compared with no alcohol consumption in the prior 24 hours. Consuming wine, beer, or liquor, was each associated with an increased risk of gout attack.

Conclusions

Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Persons with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.