Alcohol consumption tied to tophi development in gout patients: Study

China: In patients with gout, longer duration and higher quantity of alcohol consumption as well as spirits consumption are predictors for the development of ultrasound (US)-detected tophi and sub-tophi, states an article published in the Arthritis Care & Research.

Gout is an inflammatory and metabolic disease, characterized by the deposition of monosodium urate (MSU) crystals called tophi. About 12–35% of people with gout tend to develop tophi. Tophi present as large bumps, where uric acid gout crystals have accumulated and settled in one or more joints, or subcutaneous and other tissues.

Tophi may be underdiagnosed because they are hard to find with only a physical examination. Recent studies support the positive role of ultrasound in the early diagnosis of gout and in monitoring treatment response as it is sensitive to detecting MSU deposition. All types of alcohol are known to affect gout, but the impact on flares and symptoms may vary by type of alcohol. Even a light-to-moderate amount, triggers recurrent gout attacks. Studies have shown that excessive alcohol intake may substantially increase blood uric acid levels and promote tophi formation.

Lin Han, Qingdao University, China and colleagues conducted a study to examine the association of alcohol consumption with the presence and development of ultrasound (US)-detected tophi and subcutaneous tophi (sub-tophi) in   gout patients

Researchers included a total of 554 patients with gout who underwent the US and physical examination on the most frequently involved joints in gout for the present study. Multivariable analysis was performed to assess the associations of the duration, quantity, and type of alcohol consumption with the presence, size, and the number of US-detected tophi and sub-tophi.

Key findings of the study,

• Compared with non-drinkers, excessive drinkers (>70 g/week), long-term drinkers (≥10 years), and spirits drinkers had a greater proportion, size, and number of US-detected tophi and sub-tophi.

• After adjusting for confounders, excessive drinking (OR-1.79; OR: 2.00), long-term alcohol consumption (OR: 1.96; OR: 2.17), and spirits consumption of (OR: 1.81; OR: 2.10) were significantly associated with the presence of US-detected tophi and sub-tophi, with the highest OR among the identified risk factors.

• Among patients who already had US-detected tophi or sub-tophi, moderate drinking (≤ 70 g/week) was associated with larger or multiple tophi.

The authors conclude that determining the amount and duration of alcohol consumption as well as spirits consumption can help to predict the development of US-detected tophi and sub-tophi in patients with gout. Among people who have US-detected tophi and sub-tophi, weekly alcohol consumption leads to the development of tophi regardless of the amount consumed.

Reference:

Lin Han PhD,Runze Li MD,Jie Lu PhD,Wei Ren MD,Chunping Ning PhD,Jingyuan Pang BD,Jian Sun MD,Yao Wang MD,Wenyan Sun PhD,Zhen Liu PhD,Can Wang MD,Xuefeng Wang MD. First published: 13 June 2022 https://doi.org/10.1002/acr.24968