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Rationale:
- Alcoholic beverages may contain both ethanol and uric acid precursors that elevate uric acid levels.
- Some forms of ethanol, such as that in “moonshine” and adulterated wines, have significant levels of lead, which impairs uric
acid secretion in the kidney and may increase uric acid production that affects the bone marrow, resulting in ineffective
erythropoiesis.
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Evidence:
- Ethanol increases uric acid production (18) and, to a lesser degree, may impair uric acid secretion in the kidney.
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Comments:
- A case-control study comparing men with and without gout showed that those with gout had higher levels of ethanol consumption;
the weight-to-height ratio had a linear effect on gout occurrence independent of the body mass ratio (36).
- A longitudinal questionnaire study utilizing the American College of Rheumatology criteria for gout queried 47,150 individuals
in the Health Professionals Follow-up Study regarding ethanol intake and incident gout. Beer and, to a lesser extent, spirits
intake made incident gout more likely, whereas wine intake did not have a statistical effect (37).
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Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
> Non-drug Therapy
