Effect of Dietary and Supplemental Omega‐3 Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares

Abstract

Objective To determine the relationship between omega‐3 polyunsaturated fatty acid (n‐3 PUFA) consumption (dietary or supplemental) and risk of gout flares. Methods We used data from the Boston University Online Gout Study, an internet‐based case‐crossover study conducted from February 2003 to January 2012. At the times of gout flares (hazard period) and during gout flare–free periods (control periods), participants completed questionnaires regarding exposures, including supplements and diet, during the preceding 48 hours. We examined the relationship of self‐reported n‐3 PUFA–rich supplements and fish intake with the risk of recurrent gout flares using conditional logistic regression, adjusting for total purine intake, diuretic use, and other urate‐lowering or flare prophylactic medications (allopurinol, nonsteroidal antiinflammatory drugs, or colchicine). Results Of the 724 participants, 85% met the 1977 American College of Rheumatology preliminary criteria for the classification of the acute arthritis of primary gout. Twenty‐two percent of the participants reported some form of n‐3 PUFA consumption (supplements, 4.6%; dietary fatty fish, 19%) in the 48 hours preceding a gout flare or flare‐free period. The adjusted odds ratios were 1.01 (95% confidence interval [95% CI] 0.63–1.60; P = 0.98) for all 3 supplements combined and 0.74 (95% CI 0.54–0.99; P = 0.04) for consumption of ≥2 n‐3 PUFA–rich fish servings. Conclusion Dietary n‐3 PUFA–rich fish consumption, when adjusted for total purine intake, was associated with lower risk of recurrent gout flares, whereas n‐3 PUFA supplementation alone, as taken in a self‐directed manner, was not. Consumption of specific sources and adequate doses of n‐3 PUFA for gout flare prevention warrants further study in an adequately powered clinical trial.

Differences in the serum metabolome and lipidome identify potential biomarkers for seronegative rheumatoid arthritis versus psoriatic arthritis

“…While L3 and L5 can mostly associate with changes in levels of lipids in the sera, since they reflect the lipid β-methylenes and α-methylenes, common to most medium and long-chain fatty acids, the L6 group reflects polyunsaturated allylic methylenes due to the presence of polyunsaturated fatty acids (PUFAs), which are known to play a central role in the homeostasis of the immune system. PUFAs have been associated with both proinflammatory (ω6-PUFAs) and anti-inflammatory (ω3-PUFAs) features 44–46…”

Omega-3 Polyunsaturated Fatty Acids Inhibit the Function of Human URAT1, a Renal Urate Re-Absorber

“…With respect to gout, a small case-control study on patients with this inflammatory condition showed an association between high ω-3 FA levels in the blood and lower frequency of gout attacks [23]. Additionally, ω-3 PUFA-rich fish consumption was reportedly associated with lower risk of recurrent gout attacks in a case-crossover study [24]. Moreover, the anti-inflammatory effects of ω-3 PUFAs were supported by the results obtained in animal models of acute inflammation induced by monosodium urate crystals [25,26].…”

Dietary and Nutritional Strategy for the Prevention and Management of Hyperuricemia

“…A study reported that consumption of fish containing omega-3 PUFA was associated with a lower propensity of recurrent gout flares. [35,36] The exact mechanism is elucidated to be as follows: inhibition of caspase-1 activation, IL-1β secretion, inhibition of NLRP3 inflammasome activation and chemotaxis. [37] Other therapies which show promise in treating gout, but require further research include guava leaves, red ginger and cocoa.…”