Genetics May Contribute to Gout Risk More than Diet

The risk of hyperuricaemia (elevated serum urate concentration), a common gout risk factor, may come more from genes than diet, according to a recent study. 

A meta-analysis of five cohort studies, published in The BMJ, included 16,760 people (8,414 men and 8,346 women) aged > 18 who did not have kidney disease or gout and were not on urate-lowering or diuretic drugs. Serum urate measurements, dietary survey data, information on potential confounders, and genome wide genotypes were all recorded. 

New research finds that diet is substantially less important than genes in the development of high blood urate levels, that often precede gout https://t.co/XMDvMnWgom @AucklandUni @otago pic.twitter.com/PB0LAjlZfb

— The BMJ (@bmj_latest) October 16, 2018

Researchers associated seven foods with elevated serum urate levels (beer, liquor, wine, potato, poultry, soft drink, and meat [beef, pork, or lamb]) and eight with decreased serum urate levels (eggs, peanuts, cold cereal, skim milk, cheese, brown bread, margarine, and non-citrus fruit). Beer and liquor were most strongly correlated with raised serum urate levels (1.38 μmol/L per week), equating to a 9.66 μmol/L (0.16 mg/dL) increase per daily serving. The total 63 food items the researchers studied explained 4.29% of variation in serum urate levels. In contrast, genetic risk score explained 7.9% of the varying serum urate levels.

Studies analyze causes of #hyperuricemia, kidney effects of #gout treatment with allopurinol. Learn more in the latest ACP Internist Weekly https://t.co/rqo8jZqBsP. pic.twitter.com/PTI68X4U31

— ACP (@ACPIMPhysicians) October 16, 2018

“Thus, in the datasets analysed here, overall diet explains much less variance in serum urate levels when compared with inherited genetic variants,” the researchers wrote. 

One limitation of the present study is that the questionnaires were not identical in each of the studies the team analyzed. But the study still challenges the centuries-held belief that diet is a significant risk factor for gout development. 

Absolutely fascinating study (and picture too), on the role of diet in serum urate levels, by Major et al (2018) @bmj_latest #MedEd #FOAMed #CardioEd pic.twitter.com/OkqglPH6Cc

— David Warriner (@DrDavidWarriner) October 13, 2018

“Our results challenge widely held community perceptions that hyperuricaemia is primarily caused by diet, showing that genetic variants have a much greater contribution to hyperuricaemia in the general population than dietary exposure,” the study authors concluded. 

Study: Obesity, Hypertension, and Diuretic Use Linked to Gout 

The economic burden of uncontrolled gout: how controlling gout reduces cost 

Decreased incidence of diabetes in patients with gout using benzbromarone 

Gout Medication Not Associated with Kidney Function Decline 

Source: The BMJ