Li Qian-Hua, Zou Yao-Wei, Lian Shu-Yan, Liang Jin-Jian, Bi Yu-Fei, Deng Chao, Mo Ying-Qian, Yang Kui-Min, Dai Lie
Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Rheumatology, Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University, Shanwei, China.
Front Nutr. 2022 Jul 12;9:916811. doi: 10.3389/fnut.2022.916811. eCollection 2022.
Early onset gout has received increasing interest from researchers. Previous studies have reported that serum urate (sUA) levels and prevalence of obesity are higher in early onset gout patients than in later-onset gout patients. We explored the dietary habits of early onset and later-onset gout patients and their association with clinical features.
Gout patients completed a 10-item food frequency questionnaire. Early onset gout patients were defined as gout onset before the age of 40, and onset after age 40 was classified as later-onset. Associations between dietary factors, obesity, and sUA level of ≥600 μmol/L were assessed using logistic regression.
Among the 655 gout patients, 94.6% were males, and 59.1% presented with early onset gout. All early onset patients were males. sUA level was significantly higher in the early onset group than in the later-onset group (550.7 vs. 513.4 μmol/L). The proportion of patients with a sUA level of ≥ 600 μmol/L (40.3 vs. 26.2%) and obesity (27.6 vs. 10.7%) was higher in the early onset group than in the later-onset group (all < 0.05). The early onset group consumed more red meat (101-200 g/day: 43.6 vs. 26.0%), sugar-sweetened beverages (>4 times/week: 27.9 vs. 7.7%), and milk and milk products (1-2 times/week: 28.5 vs. 16.6%), but less alcohol (>84 g/day: 8.5 vs. 21.5%) and tea (>4 times/week: 35.7 vs. 52.4%; all < 0.05). Sugar-sweetened beverage intake was positively correlated with sUA level of ≥600 μmol/L (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.4, 3.7) and obesity (compared with <once/week [reference], >4 times/week: adjusted odds ratio = 2.2, 95% confidence interval: 1.2, 3.7). These correlations remained significant for early onset gout patients.
Sugar-sweetened beverage intake replaced alcohol as the main dietary risk factor for gout in early onset patients, and this change was associated with a greater prevalence of obesity and higher sUA level. Clinicians should provide specific dietary education for different generations of gout patients. The epidemic of sugar-sweetened beverage consumption should be considered for the development of public health policies for the prevention of gout.
早发性痛风越来越受到研究人员的关注。先前的研究报道，早发性痛风患者的血清尿酸（sUA）水平和肥胖患病率高于晚发性痛风患者。我们探讨了早发性和晚发性痛风患者的饮食习惯及其与临床特征的关联。
痛风患者完成了一份包含10个项目的食物频率问卷。早发性痛风患者定义为痛风发病年龄在40岁之前，40岁及以后发病的归类为晚发性。使用逻辑回归评估饮食因素、肥胖与sUA水平≥600μmol/L之间的关联。
在655例痛风患者中，94.6%为男性，59.1%为早发性痛风。所有早发性患者均为男性。早发性组的sUA水平显著高于晚发性组（550.7 vs. 513.4μmol/L）。sUA水平≥600μmol/L的患者比例（40.3% vs. 26.2%）和肥胖患者比例（27.6% vs. 10.7%）早发性组高于晚发性组（均P<0.05）。早发性组食用更多的红肉（101 - 200克/天：43.6% vs. 26.0%）、含糖饮料（>4次/周：27.9% vs. 7.7%）以及牛奶和奶制品（1 - 2次/周：28.5% vs. 16.6%），但饮酒（>84克/天：8.5% vs. 21.5%）和喝茶（>4次/周：35.7% vs. 52.4%；均P<0.05）较少。含糖饮料摄入量与sUA水平≥600μmol/L呈正相关（与<每周1次[参照]相比，>4次/周：调整优势比 = 2.2，95%置信区间：1.4，3.7）以及与肥胖呈正相关（与<每周1次[参照]相比，>4次/周：调整优势比 = 2.2，95%置信区间：1.2，3.7）。这些相关性在早发性痛风患者中仍然显著。
在早发性患者中，含糖饮料的摄入取代了酒精成为痛风的主要饮食风险因素，这种变化与更高的肥胖患病率和更高的sUA水平相关。临床医生应为不同年龄段的痛风患者提供特定的饮食教育。在制定预防痛风的公共卫生政策时应考虑含糖饮料消费的流行情况。
