The first large epidemiological study to assess the age-old belief that alcohol consumption increases the risk of
gout is published in this week's issue of THE LANCET. A prospective study of nearly 50,000 men showed that beer drinking was more likely to be associated with
gout than spirits; whereas moderate wine consumption was not linked to a risk of the disease.
Alcohol consumption causes hyperuricaemia (increased production of uric acid) which when deposited in joints leads to gout. The association between alcohol consumption and risk of gout has been suspected since ancient times, but has not been prospectively confirmed. Additionally, potential differences in risk of gout posed by different alcoholic beverages have not been assessed.
Hyon K Choi from Massachusetts General Hospital, USA, and colleagues prospectively assessed alcohol consumption and incidence of gout among 47000 male medical staff over a 12-year period. 730 cases of gout were confirmed throughout the study period. Alcohol consumption was assessed as the quantity consumed relative to the typical ethanol content of alcoholic drinks: 12*8 g for one can of beer, 11*0 g for a glass of wine, and 14*0 g for a shot of spirits.
Compared with people who did not drink, alcohol consumption was linked to gout risk, with higher overall consumption increasing this risk: around a 30% increased risk for daily alcohol consumption between 10 and 15g; around 50% increased risk for daily consumption between 15 and 30g; around a doubling of gout risk for consumption between 30 and 50g; and a 2*5 times increased risk for a daily alcohol consumption above 50g.
Beer consumption showed the strongest independent association with the risk of gout; consumption of spirits had a weaker association, while moderate wine consumption was not associated with increased gout risk.