Fructose-rich beverages and risk of gout in women.
Fructose-rich beverages and risk of gout in women.
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DOI：
10.1001/jama.2010.1638
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发表时间：
2010-11-24
影响因子：
120.7
通讯作者：
Curhan, Gary
中科院分区：
文献类型：
--
作者：
Choi, Hyon K;Willett, Walter;Curhan, Gary
富含果糖的饮料，如加糖苏打水和橙子汁，可以增加血清尿酸水平，从而增加痛风的风险，但关于这种关系的前瞻性数据有限。研究富含果糖的饮料和果糖的摄入量与女性发生痛风风险之间的关系。前瞻性队列研究超过22年（1984-2006）护士健康研究78,906名基线时无痛风史的妇女，通过经验证的食物频率问卷提供有关饮料和果糖摄入量的信息。符合美国风湿病学会痛风调查标准的痛风事件病例。在22年的随访中，我们记录了778例确诊的痛风事件。增加含糖苏打水的摄入量与痛风风险增加独立相关。与<1份/月的摄入量相比，痛风的多变量相对风险为1.74（95%置信区间[CI]，1.19至2.25）（1份/天）和2.39（1.34至4.26）（≥ 2份/天）（趋势P <0.001）。橙子汁的相应RR为1.41（95% CI，1.03 - 1.93）和2.42（95% CI，1.27 - 4.63）（趋势P =0.02）。与这些RR相对应的绝对风险差异，含糖汽水为36和68例/100，000人年，橙子汁为14和47例/100，000人年。无糖软饮料与痛风风险无关（趋势P =0.27）。与果糖摄入量最低的五分位数相比，最高五分位数中痛风的多变量相对风险为1.62（95%CI，1.20至2.19）（趋势P =0.004）（风险差异为每10万人年28例）。这些前瞻性数据表明，富含果糖的饮料的消费增加了女性痛风发病的风险，尽管考虑到女性发病率较低，它们对人群痛风风险的贡献可能不大。
Fructose-rich beverages such as sugar-sweetened soda and orange juice can increase serum uric acid levels and thus, the risk of gout, but prospective data on the relation is limited. To examine the relation between intake of fructose-rich beverages and fructose and the risk of incident gout among women. Prospective cohort study over 22 years (1984-2006) The Nurses’ Health Study 78,906 women with no history of gout at baseline who provided information on intake of beverages and fructose through validated food-frequency questionnaires. Incident cases of gout that met the American College of Rheumatology survey criteria for gout. During 22 years of follow-up, we documented 778 confirmed incident cases of gout. Increasing intake of sugar-sweetened soda was independently associated with increasing risk of gout. Compared with consumption of <1 serving/month, the multivariate relative risk of gout was 1.74 (95% confidence interval [CI], 1.19 to 2.25) for 1 serving/day and 2.39 (1.34 to 4.26) for ≥ 2 serving/day (P for trend<0.001). The corresponding RRs for orange juice were 1.41 (95% CI, 1.03 to 1.93) and 2.42 (95% CI, 1.27 to 4.63) (P for trend=0.02). The absolute risk differences corresponding to these RRs were 36 and 68 cases per 100,000 person-years for sugar-sweetened soda and 14 and 47 per 100,000 cases person-years for orange juice. Diet soft drinks were not associated with the risk of gout (P for trend=0.27). Compared with the lowest quintile of fructose intake, the multivariate relative risk of gout in the top quintile was 1.62 (95% CI, 1.20 to 2.19) (P for trend=0.004) (risk difference of cases 28 per 100,000 person-years). These prospective data suggest that consumption of fructose-rich beverages increases the risk of incident gout among women, although their contribution to the risk of gout in the population is likely modest given the low incidence rate among women.