Sugar-sweetened beverage consumption: a risk factor for prevalent gout withSLC2A9genotype-specific effects on serum urate and risk of gout

Abstract

ObjectiveConsumption of high fructose corn syrup (HFCS)-sweetened beverages increases serum urate and risk of incident gout. Genetic variants in SLC2A9, that exchanges uric acid for glucose and fructose, associate with gout. We tested association between sugar (sucrose)-sweetened beverage (SSB) consumption and prevalent gout. We also tested the hypothesis that SLC2A9 genotype and SSB consumption interact to determine gout risk.MethodsParticipants were 1634 New Zealand (NZ) European Caucasian, Ma¯ori and Pacific Island people and 7075 European Caucasians from the Atherosclerosis Risk in Communities (ARIC) study. NZ samples were genotyped for rs11942223 and ARIC for rs6449173. Effect estimates were multivariate adjusted.ResultsSSB consumption increased gout risk. The OR for four drinks/day relative to zero was 6.89 (p=0.045), 5.19 (p=0.010) and 2.84 (p=0.043) for European Caucasian, Ma¯ori and Pacific Islanders, respectively. With each extra daily SSB serving, carriage of the gout-protective allele of SLC2A9 associated with a 15% increase in risk (p=0.078), compared with a 12% increase in non-carriers (p=0.002). The interaction term was significant in pooled (pInteraction=0.01) but not meta-analysed (pInteraction=0.99) data. In ARIC, with each extra daily serving, a greater increase in serum urate protective allele carriers (0.005 (p=8.7×10−5) compared with 0.002 (p=0.016) mmol/L) supported the gout data (pInteraction=0.062).ConclusionsAssociation of SSB consumption with prevalent gout supports reduction of SSB in management. The interaction data suggest that SLC2A9-mediated renal uric acid excretion is physiologically influenced by intake of simple sugars derived from SSB, with SSB exposure negating the gout risk discrimination of SLC2A9.

Gout: an Asia‐Pacific update

“…53,54 The major pharmacological agents used for acute gouty arthritis include non-steroidal anti-inflammatory drugs (NSAIDs), colchicine and glucocorticoids. During acute attacks, urate-lowering therapy is better avoided as it can cause further flare-up of arthritis.…”

Can glyphosate’s disruption of the gut microbiome and induction of sulfate deficiency explain the epidemic in gout and associated diseases in the industrialized world?

“…Fructose is a well-established risk factor for gout [90]. A study based in New Zealand found that Caucasians consuming four or more drinks sweetened with high-fructose corn syrup per day had a nearly sevenfold increased risk for gout compared to those consuming none [91]. It has been argued that fructose metabolism by the gut bacteria is disrupted by glyphosate, in part due to its blockage of the shikimate pathway [49], and this would result in an excessive concentration of fructose delivered to the colon, which would likely promote the growth of fungi.…”

Association between Sugar-Sweetened Beverage Consumption and the Risk of Gout: A Meta-Analysis

“…One study of the four studies was excluded due to a repeated publication with same population [20]. Thus, three studies were included [7][8][9] (Figure 1). One of the eligible studies contained data on four different groups, and these were treated independently [7].…”

“…Eight hundred and eighty articles were identified using electronic databases and manual searches, and 4 were selected for a full-text review on the basis of the title and abstract details [7][8][9]20]. One study of the four studies was excluded due to a repeated publication with same population [20].…”

“…The substantial increase in SSB consumption is associated with hyperuricemia [6], which is recognized as the most important risk factor for gout. Several studies investigated whether SSB consumption is associated with gout development [7][8][9]. However, the role of SSBs in the development of gout has not been quantitatively reviewed.…”