title: Alcohol consumption as a trigger of recurrent gout attacks.
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.
  
  
  CONCLUSIONS
  Alcohol consumption triggers recurrent gout attacks. This effect was likely to occur within 24 hours after its consumption.
authors.affiliation: Boston University Clinical Epidemiology Research and Training Unit, the Department of Medicine at Boston Medical Center, Boston, Mass 02118, USA. yuqing@bu.edu
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ryan
authors.initials: R
authors.lastname: Woods
authors.forename: Christine E
authors.initials: CE
authors.lastname: Chaisson
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.forename: Jingbo
authors.initials: J
authors.lastname: Niu
authors.forename: Timothy E
authors.initials: TE
authors.lastname: McAlindon
authors.forename: David
authors.initials: D
authors.lastname: Hunter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D000434:Alcoholic Beverages / Q000009:adverse effects; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006073:Gout / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors