Purine-rich foods intake and recurrent gout attacks.
OBJECTIVE
To examine and quantify the relation between purine intake and the risk of recurrent gout attacks among gout patients.


METHODS
The authors conducted a case-crossover study to examine associations of a set of putative risk factors with recurrent gout attacks. Individuals with gout were prospectively recruited and followed online for 1 year. Participants were asked about the following information when experiencing a gout attack: the onset date of the gout attack, clinical symptoms and signs, medications (including antigout medications), and presence of potential risk factors (including daily intake of various purine-containing food items) during the 2-day period prior to the gout attack. The same exposure information was also assessed over 2-day control periods.


RESULTS
This study included 633 participants with gout. Compared with the lowest quintile of total purine intake over a 2-day period, OR of recurrent gout attacks were 1.17, 1.38, 2.21 and 4.76, respectively, with each increasing quintile (p for trend <0.001). The corresponding OR were 1.42, 1.34, 1.77 and 2.41 for increasing quintiles of purine intake from animal sources (p for trend <0.001), and 1.12, 0.99, 1.32 and 1.39 from plant sources (p=0.04), respectively. The effect of purine intake persisted across subgroups by sex, use of alcohol, diuretics, allopurinol, NSAIDs and colchicine.


CONCLUSIONS
The study findings suggest that acute purine intake increases the risk of recurrent gout attacks by almost fivefold among gout patients. Avoiding or reducing amount of purine-rich foods intake, especially of animal origin, may help reduce the risk of gout attacks.
Boston University, Boston University School of Medicine, 715 Albany Street, A203, Boston, Massachusetts, MA 02118, USA. yuqing@bu.edu
Yuqing
Y
Zhang
Clara
C
Chen
Hyon
H
Choi
Christine
C
Chaisson
David
D
Hunter
Jingbo
J
Niu
Tuhina
T
Neogi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018592:Cross-Over Studies; D004032:Diet / Q000009:adverse effects*; D005260:Female; D006073:Gout / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011687:Purines / Q000009:adverse effects*; D012307:Risk Factors; D055815:Young Adult
D011687:Purines