Department of Nutrition and Food Hygiene, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China.
Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
JAMA Netw Open. 2024 Aug 1;7(8):e2430700. doi: 10.1001/jamanetworkopen.2024.30700.
Previous studies on alcohol consumption and incident gout have mostly included men or combined both sexes, and the sex-specific associations between alcohol consumption and gout are poorly understood.
To evaluate the consumption of total and specific alcoholic beverages in association with incident gout in men and women.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included 401 128 participants in the UK Biobank aged 37 to 73 years who were free of gout at baseline (2006-2010). Participants were followed up through December 31, 2021, and data were analyzed between August 2023 and June 2024.
Questionnaire-based consumption of total alcohol and specific alcoholic beverages.
The outcome was incident gout, identified using hospital records. Multivariable Cox proportional hazards regression models were used to estimate sex-specific hazard ratios (HRs) and 95% CIs of incident gout associated with alcohol consumption, with a particular consideration of reverse causation bias.
The main analysis included 179 828 men (mean [SD] age, 56.0 [8.2] years) and 221 300 women (mean [SD] age, 56.0 [8.0] years). Current drinkers showed a higher risk of gout than never drinkers among men (HR, 1.69; 95% CI, 1.30-2.18) but not among women (HR, 0.83; 95% CI, 0.67-1.03). Among current drinkers, higher total alcohol consumption was associated with a higher risk of gout among both sexes and more strongly among men than women (men: HR, 2.05 [95% CI, 1.84-2.30]; women: HR, 1.34 [95% CI, 1.12-1.61]). The most evident sex difference in the consumption of specific alcoholic beverages was observed for beer or cider (men: mean [SD], 4.2 [4.8] pints per week; women: mean [SD], 0.4 [1.1] pints per week). Consumption of champagne or white wine, beer or cider, and spirits each was associated with a higher risk of gout among both sexes, with beer or cider showing the strongest association per 1 pint per day (men: HR, 1.60 [95% CI, 1.53-1.67]; women: HR, 1.62 [95% CI, 1.02-2.57]). Some inverse associations between light to moderate consumption of specific alcoholic beverages and gout were eliminated after adjusting for other alcoholic beverages and excluding individuals who had reduced alcohol consumption for health reasons, self-reported poor health, or had cardiovascular disease, cancer, or kidney failure at baseline, or developed gout within the first 2 years of follow-up.
In this cohort study, higher consumption of several specific alcoholic beverages was associated with a higher risk of gout among both sexes. The sex-specific associations for total alcohol consumption may be associated with differences between men and women in the types of alcohol consumed.
之前关于饮酒与痛风发作的研究大多包括男性或同时包含两性，而酒精摄入与痛风之间的性别特异性关联仍知之甚少。
评估男性和女性中总饮酒量和特定酒类饮料的摄入量与痛风发作的相关性。
设计、地点和参与者：这项前瞻性队列研究纳入了英国生物库中年龄在 37 至 73 岁之间、基线时无痛风（2006-2010 年）的 401128 名参与者。参与者的随访时间截至 2021 年 12 月 31 日，数据分析于 2023 年 8 月至 2024 年 6 月进行。
基于问卷的总饮酒量和特定酒类饮料的摄入量。
主要结局为痛风发作，通过医院记录确定。使用多变量 Cox 比例风险回归模型估计与饮酒相关的痛风发作的性别特异性风险比（HR）和 95%置信区间（CI），特别考虑了反向因果关系偏差。
主要分析包括 179828 名男性（平均[标准差]年龄，56.0[8.2]岁）和 221300 名女性（平均[标准差]年龄，56.0[8.0]岁）。与从不饮酒者相比，当前饮酒者的痛风发作风险更高，这种关联在男性中更为明显（HR，1.69；95%CI，1.30-2.18），但在女性中并不明显（HR，0.83；95%CI，0.67-1.03）。在当前饮酒者中，总饮酒量越高，痛风发作的风险也越高，且男性中的关联强于女性（男性：HR，2.05[95%CI，1.84-2.30]；女性：HR，1.34[95%CI，1.12-1.61]）。在特定酒类饮料的摄入方面，男女之间最明显的性别差异体现在啤酒或苹果酒上（男性：平均[标准差]，4.2[4.8]品脱/周；女性：平均[标准差]，0.4[1.1]品脱/周）。香槟或白葡萄酒、啤酒或苹果酒和烈性酒的摄入均与两性痛风发作风险的增加相关，其中啤酒或苹果酒与每天 1 品脱的关联最强（男性：HR，1.60[95%CI，1.53-1.67]；女性：HR，1.62[95%CI，1.02-2.57]）。在调整其他酒类饮料摄入量、排除因健康原因、自我报告健康状况不佳或基线时患有心血管疾病、癌症或肾衰竭而减少饮酒量、或在随访的前 2 年内发生痛风的个体后，一些特定酒类饮料的轻至中度摄入与痛风之间的负相关关联消失了。
在这项队列研究中，几种特定酒类饮料的较高摄入量与两性痛风发作的风险增加相关。总饮酒量的性别特异性关联可能与男性和女性饮酒类型的差异有关。
