A study of Caucasians and Polynesians in both the US and New Zealand explains why sugary drinks worsen gout.
Batt C, Phipps-Green AJ, Black MA, et al., Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout.Ann Rheum Dis. (2013) Sep 11. doi: 10.1136/annrheumdis-2013-203600. [Epub ahead of print] (Open access)
Beverages sweetened with sucrose boost levels of serum urate and can increase the risk of gout, especially in people with variants of a gene called SLC2A9, according to a study that involves
European Caucasian and Polynesian populations in New Zealand and the United States.
The 1,634 participants in New Zealand participants drank beverages sweetened with sucrose (sugar). The 7,075 European Caucasians in the long-running Atherosclerosis Risk in Communities (ARIC) study live in the US, where high fructose corn syrup (HFCS) is a more common sweetener.
The 925 in New Zealand were diagnosed with gout according to ACR criteria, while the 148 US patients self-reported a physician's diagnosis of gout.
Both groups were genotyped for variants of SLC2A9, which regulates the exchange of uric acid for glucose and fructose. Fructose and glucose may interfere with uric acid excretion, increasing serum urate and gout risk. HFCS is also associated with a higher risk of gout.
Variants of the gene are strongly associated with gout in both populations, and researchers find the more servings of sugar-sweetened beverages (SSBs) the greater the risk of gout.
This was particularly true for the New Zealanders who drank more than 4 servings a day of sugar-sweetened beverages. Each additional serving conferred a 15% increase in gout risk among carriers of one gene variant. The US-based ARIC population also showed an increase in gout risk with each extra serving of a sugary beverage.
The data suggest that sweeteners in beverages alter the ability of SLC2A9 to transport uric acid , the authors conclude. More importantly, they strongly support reducing consumption of sweetened beverages to reduce the effects of gout.