Immuno-Rheumatology Center, St Luke's International Hospital, Tokyo, Japan.
Graduate School of Public Health, St Luke's International University, Tokyo, Japan.
JAMA Netw Open. 2023 Mar 1;6(3):e233398. doi: 10.1001/jamanetworkopen.2023.3398.
Differences have been observed in the association of serum urate levels with consumption of different types of alcoholic beverages. However, previous studies have not standardized the unit of intake for ethanol content, and only limited types of alcoholic beverages have been evaluated.
To examine differences in the association of serum urate levels with various types of alcoholic beverages when their intakes are standardized for ethanol content.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study was conducted using data from participants aged 20 years or older who completed a medical checkup at St Luke's International University in Japan between October 1, 2012, and October 31, 2021. Participant demographics, blood test results, and lifestyle questionnaire data were used as covariates. Analysis was performed in December 2021.
Consumption of alcoholic beverages, including beer, sake (rice wine), shochu (Japanese spirit), wine, and whiskey.
Serum urate levels were measured during the medical checkup. The beverage unit was standardized to 1 standard drink, which contained 20 g of ethanol. Multivariable linear regression including interaction terms of alcohol consumption and dominant alcoholic beverage was performed.
This study included 78 153 participants. Their mean (SD) age was 47.6 (12.8) years; 36 463 (46.7%) were men and 41 690 were women (53.3%). A total of 45 755 participants (58.5%) were regular alcohol drinkers. Consistent associations of serum urate levels with alcohol consumption were observed in the beer-dominant group, with β coefficients (for 1 standard drink per day) of 0.14 mg/dL (95% CI, 0.11-0.17 mg/dL; P < .001) for men and 0.23 mg/dL (95% CI, 0.20-0.26 mg/dL; P < .001) for women. A moderate increase in serum urate levels was observed in the wine-dominant group compared with a modest and nonsignificant increase in the sake-dominant group, with β coefficients (for 1 standard drink per day) for the latter group of 0.05 mg/dL (95% CI, -0.01 to 0.10; P = .10) for men and 0.04 mg/dL (95% CI, -0.05 to 0.14 mg/dL; P = .38) for women. Restricted cubic splines showed different patterns in associations of serum urate levels with ethanol intake by dominant alcoholic beverages.
The results of this study suggest that the extent of the association of serum urate levels with alcohol intake was different for alcoholic beverages even after ethanol content was standardized. Higher beer consumption among men and women was consistently associated with higher serum urate levels, whereas sake was not associated with changes in serum urate levels. Therefore, alcoholic beverage type, in addition to ethanol content, should be considered as a factor contributing to hyperuricemia.
已经观察到血清尿酸水平与不同类型的酒精饮料摄入之间存在差异。然而，以前的研究没有标准化乙醇含量的摄入量单位，并且仅评估了有限类型的酒精饮料。
当标准化各种酒精饮料的乙醇含量摄入量时，研究血清尿酸水平与各种酒精饮料之间的关联差异。
设计、设置和参与者：本回顾性横断面研究使用了 20 岁或以上在日本圣卢克国际大学接受体检的参与者的数据，这些参与者于 2012 年 10 月 1 日至 2021 年 10 月 31 日期间完成了体检。参与者的人口统计学数据、血液测试结果和生活方式问卷调查数据被用作协变量。分析于 2021 年 12 月进行。
包括啤酒、清酒（米酒）、烧酒（日本烈酒）、葡萄酒和威士忌在内的酒精饮料消费。
在体检期间测量血清尿酸水平。饮料单位被标准化为 1 标准份，其中含有 20 克乙醇。进行了包括酒精摄入量和主要酒精饮料的交互项的多变量线性回归。
这项研究纳入了 78153 名参与者。他们的平均（标准差）年龄为 47.6（12.8）岁；36463 名（46.7%）为男性，41690 名女性（53.3%）。共有 45755 名参与者（58.5%）经常饮酒。在啤酒为主的组中，血清尿酸水平与酒精摄入之间存在一致的关联，男性的β系数（每天 1 标准份）为 0.14mg/dL（95%CI，0.11-0.17mg/dL；P<.001），女性为 0.23mg/dL（95%CI，0.20-0.26mg/dL；P<.001）。与以清酒为主的组相比，葡萄酒为主的组中血清尿酸水平适度升高，而以清酒为主的组中血清尿酸水平略有升高且无统计学意义，后者的β系数（每天 1 标准份）为男性 0.05mg/dL（95%CI，-0.01 至 0.10；P=0.10），女性为 0.04mg/dL（95%CI，-0.05 至 0.14mg/dL；P=0.38）。受限立方样条显示血清尿酸水平与主要酒精饮料的乙醇摄入之间的关联存在不同模式。
这项研究的结果表明，即使标准化了乙醇含量，血清尿酸水平与酒精摄入之间的关联程度也因酒精饮料而不同。男性和女性中较高的啤酒摄入量与较高的血清尿酸水平持续相关，而清酒与血清尿酸水平的变化无关。因此，除了乙醇含量外，酒精饮料类型也应被视为导致高尿酸血症的因素之一。
