Alcohol quantity and type on risk of recurrent gout attacks: an internet-based case-crossover study.
OBJECTIVE
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 US among participants with gout and who had at least one attack during the 1 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 <.001 for trend). The risk of recurrent gout attack was 1.36 (95% confidence interval [CI], 1.00-1.88) and 1.51 (95% CI, 1.09-2.09) 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. Individuals with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks.
Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Mass. Electronic address: tneogi@bu.edu.
Tuhina
T
Neogi
Data Coordinating Center, Boston University School of Public Health, Boston, Mass.
Clara
C
Chen
Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Mass.
Jingbo
J
Niu
Data Coordinating Center, Boston University School of Public Health, Boston, Mass.
Christine
C
Chaisson
Kolling Institute, University of Sydney and Royal North Shore Hospital, New South Wales, Australia.
David J
DJ
Hunter
Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Mass.
Yuqing
Y
Zhang
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; D005260:Female; D006073:Gout / Q000209:etiology*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D055815:Young Adult
Alcohol; Case-crossover; Gout attacks; Internet; Triggers