Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Association Between Sugar-Sweetened Beverage Consumption and Gout in the New Zealand Population.
Merriman1, Tony R., Dalbeth2, Nicola, Stamp3, Lisa K., Merriman1, Marilyn E., Topless1, Ruth, Gow4, Peter J., Harrison5, Andrew
University of Otago, Dunedin, New Zealand
University of Auckland, Auckland, New Zealand
University of Otago, Christchurch, Christchurch, New Zealand
Middlemore Hospital, Auckland, New Zealand
Hutt Hospital, Lower Hutt, New Zealand
Univ of Otago Med Sch, Dunedin, New Zealand
Waikato Clinical School, Waikato Hospital, Hamilton, New Zealand
Association between the consumption of high fructose corn syrup (HFCS; 55% fructose)-sweetened beverages and fruit, and the risk of hyperuricaemia and gout, has been reported in North America. The objective was to examine the association of gout with sugar-sweetened beverages in a New Zealand (NZ) population. The population of NZ has a unique composition, and soft-drinks and fruit juices in NZ are predominantly sweetened with sucrose (50% fructose), rather than HFCS.
Survey data from 753 people with, and 633 people without, gout as determined by ACR criteria, were used to examine the association between gout and intake of sugar-sweetened beverages, including fruit juice, and fruit. One unit of drink was defined as a can or large glass. Three ethnic groups were analysed; NZ Maori, Caucasian and Western Polynesian (Samoa, Tonga, Niue). STATA v8.0 statistical software was used.
Significantly increased risk was apparent only in those drinking four or more sugar-sweetened beverages per day (Table). In all population groups, ingestion of 4 or more such drinks per day is associated with a 34-fold increased risk of gout. We observed a protective effect from daily fruit intake in the Caucasian participants (1 piece, adjusted OR=0.32, P=0.08; 23 pieces, OR=0.23, P=0.02; >=4 pieces, adjusted OR=0.15, P=0.007). There were no significant associations with fruit intake in other ethnic groups.
Table. Analysis of frequency of sugar sweetened beverage intake and gout
These results demonstrate association between increased intake of sugar-sweetened beverages and gout in all NZ ethnic groups studied. A possible mechanism for this association is the direct effect of fructose on serum urate concentrations through production of AMP and subsequently urate, as well as the long-term effects of fructose on insulin resistance and the renal excretion of urate. The observed protective effect of fruit intake in Caucasian was consistent with one North American study (Williams PT. Am J Clin Nutr. 2008;87:1480) but not a second North American study (Choi H and Curhan G. Br Med J. 2008;336:309). The protective effect of fruit, despite its fructose content, may be due to fruit containing gout-protective chemicals, or to fruit intake being a marker of a gout-protective diet.
To cite this abstract, please use the following information:
Merriman, Tony R., Dalbeth, Nicola, Stamp, Lisa K., Merriman, Marilyn E., Topless, Ruth, Gow, Peter J., et al; Association Between Sugar-Sweetened Beverage Consumption and Gout in the New Zealand Population. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1622