A recent study found that higher alcohol consumption may be associated with an increased risk of gout, with stronger associations observed in men compared with women.

The large-scale prospective cohort study, published in JAMA Network Open, investigators used the UK Biobank to examine the relationship between total and specific alcoholic beverage consumption and incident gout among 401,128 male and female participants.

The study included 179,828 men (mean [SD] age = 56.0 [8.2] years) and 221,300 women (mean [SD] age = 56.0 [8.0] years) who were free of gout at baseline (2006 to 2010). The participants were followed-up through December 31, 2021, with a median follow-up time of 12.7 years (interquartile range = 12.1–13.5 years). Alcohol consumption was assessed through questionnaires, and incident gout was identified using hospital records.

Multivariable Cox proportional hazards regression models were used to estimate sex-specific hazard ratios (HR) and 95% confidence intervals (CI) of incident gout associated with alcohol consumption. The investigators carefully considered potential reverse causation bias by excluding the participants who had reduced alcohol intake for health reasons; self-reported poor health; had cardiovascular disease, cancer, or kidney failure at baseline; or developed gout within the first 2 years of follow-up.

Participant Characteristics:

• Among men, 6,253 (2.9%) were never-drinkers, 7,792 (3.6%) were former drinkers, and 203,919 (93.6%) were current drinkers.
• Among women, 15,879 (5.9%) were never-drinkers, 9,881 (3.6%) were former drinkers, and 245,497 (90.5%) were current drinkers.

Among the key findings were:

• Current drinkers showed a higher risk of gout compared with 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 in both sexes, but more strongly in men (HR = 2.05, 95% CI = 1.84–2.30) compared with in women (HR = 1.34, 95% CI = 1.12–1.61).
• Consumption of champagne or white wine, beer or cider, and spirits was associated with a higher risk of gout in 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).
• Sex-specific associations for total alcohol consumption may be related to differences in the types of alcohol consumed by men and women.

Incident Gout Cases:

• 8,639 incident cases of gout (6,561 in men and 2,078 in women) were identified in the exploratory analysis.
• 5,278 incident cases (4,096 in men and 1,182 in women) were included in the main analysis.

Total Alcohol Consumption:

• Men who drank ≥ 5 times per week had an HR of 2.05 (95% CI = 1.84–2.30) compared with those who drank < 1 time per week.
• Women who drank ≥ 5 times per week had an HR of 1.34 (95% CI = 1.12–1.61) compared with those who drank < 1 time per week.

Specific Alcoholic Beverages:

• Beer or Cider (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)
• Spirits (per 1 measure per day): men: HR = 1.12 (95% CI = 1.06–1.19), women: HR = 1.54 (95% CI = 1.29–1.83)
• Champagne or White Wine (per 1 glass per day): men: HR = 1.24 (95% CI = 1.14–1.36), women: HR = 1.19 (95% CI = 1.01–1.40)
• Red Wine (per 1 glass per day): men: HR = 1.13 (95% CI = 1.07–1.19), women: HR = 0.92 (95% CI = 0.77–1.10)
• Fortified Wine (per 1 glass per day): men: HR = 1.26 (95% CI = 0.91–1.75), women: HR = 1.17 (95% CI = 0.64–2.11).

Consumption Patterns:

• Men consumed mean (SD) of 4.2 (4.8) pints of beer or cider per week vs 0.4 (1.1) pints per week among women
• Red wine consumption: men: mean (SD) = 2.4 (3.5) glasses per week, women: mean (SD) = 1.8 (2.7) glasses per week
• Champagne or white wine consumption: men: mean (SD) = 1.5 (2.4) glasses per week, women: mean (SD) = 1.7 (2.4) glasses per week
• Spirits consumption: men: mean (SD) = 1.3 (2.7) measures per week, women: mean (SD) = 0.8 (1.7) measures per week.

The investigators noted that 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 with potential reverse causation factors.

Study limitations included potential residual confounding, self-reported alcohol consumption data, and the identification of gout cases solely from hospital records. Additionally, the UK Biobank population was predominantly of European descent and may be healthier than the general UK population, potentially limiting generalizability.

The authors declared having no competing interests.