통풍과 술, Gout and alcohol

■ 1) 매일 맥주 1-2잔, 또는 와인 1잔 정도로 중등도로 섭취하지만 통풍 발생 위험이 높은 사람과 2) 통풍 진단을 받은 모든 환자에게 알코올 섭취 감소를 제안합니다.

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■ 통풍 진단을 받았고 요산저하제를 복용 중이며 요산 수치가 목표 수치에 있는 환자에게 소량 알코올 섭취는 통풍 발작 또는 질환 진행을 악화시키는 것 같지 않습니다.

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큰 전향적 연구에서 통풍 발생 (incident gout) 위험은 맥주 또는 증류주와 관련이 있으나 와인과는 관련이 없었습니다.

Summary

Background

The association between alcohol consumption and risk of gout has been suspected since ancient times, but has not been prospectively confirmed. Additionally, potential differences in risk of gout posed by different alcoholic beverages have not been assessed.

Methods

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Over 12 years (1986–98) we used biennial questionnaires to investigate the relation between alcohol consumption and risk of incident gout in 47 150 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain whether reported cases of gout met the American College of Rheumatology survey gout criteria.

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Findings

We documented 730 confirmed incident cases of gout. Compared with men who did not drink alcohol, the multivariate relative risk (RR) of gout was 1·32 (95% CI 0·99–1·75) for alcohol consumption 10·0–14·9 g/day, 1·49 (1·14–1·94) for 15·0–29·9 g/day, 1·96 (1·48–2·60) for 30·0–49·9 g/day, and 2·53 (1·73–3·70) for ≥50 g/day (p for trend <0·0001). Beer consumption showed the strongest independent association with the risk of gout (multivariate RR per 12-oz serving per day 1·49; 95% CI 1·32–1·70). Consumption of spirits was also significantly associated with gout (multivariate RR per drink or shot per day 1·15; 95% CI 1·04–1·28); however, wine consumption was not (multivariate RR per 4-oz serving per day 1·04; 95% CI 0·88–1·22).

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Interpretation

Alcohol intake is strongly associated with an increased risk of gout. This risk varies substantially according to type of alcoholic beverage: beer confers a larger risk than spirits, whereas moderate wine drinking does not increase the risk.

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그러나 통풍 발생 (incident gout)이 아닌 기존에 통풍이 진단된 환자에서 통풍 발작 (gout flare)은 맥주, 증류수, 와인 모두와 관련이 있었습니다.

Abstract

Objectives

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.

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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.

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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.

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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.

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■ 위에 언급하였듯이 맥주 또는 증류주는 통풍 발생 (incident gout) 위험과 관련이 있었으나 통풍 발작 (gout flare)는 맥주, 증류주, 와인 모두 관련이 있었습니다. 알코올을 많이 마시면서 퓨린이 높은 음식을 먹거나 이뇨제 사용은 flare의 높은 위험과 관련이 있었습니다.

 

ref. uptodate 2022.07.03