Background/Purpose: Gout is a consequence of an innate immune reaction to monosodium urate crystals deposited in joints. Acute gout attacks are commonly triggered by dietary factors, the most common of which have been associated with raised serum urate levels. However, individuals with gout often identify other foods as their gout triggers. The implementation of a hypothesis free diet-wide association study (DWAS) could reveal foodstuffs that have not previously been associated with urate levels. Our aim was to conduct a DWAS with serum urate as outcome. 

Methods: 13,782 individuals of European ancestry from the Atherosclerosis Risk In Communities (n=7228), Coronary Artery Risk Development In (Young) Adults (n=1413), Cardiovascular Health (n=2101) and Framingham Heart (n=3040) studies were used to test for association between serum urate (µmolL^-1) and 66 different food items (serves/week). All analyses were adjusted for sex, menopause status, age, BMI, average daily calorie intake and the first four eigenvectors from whole genome principal components analysis. Individuals with gout or kidney disease and those taking urate lowering medications or diuretics were excluded from analyses. Three quality control criteria were applied to the food consumption data to ensure reliable information was used.

Results: Six novel associations with a P < 0.0008 (Bonferroni multiple testing threshold) were found. Brown bread, peanut butter, eggs, non-citrus fruit and margarine all had urate lowering effects (β= −0.55; −0.93; −1.09; −0.35 and −0.36 µmolL^-1 per extra serve per week respectively), whilst French-fried potatoes had a urate increasing effect (β= 2.30 µmolL^-1 per extra serve per week). Additionally six known urate modifying foods, beer, cheese, shellfish, tea, skim milk and liquor (β= 1.48; −0.67; 5.11; 0.38; −0.92 and 1.63 µmolL^-1 per extra serve per week) had P-values below the multiple testing threshold. Eleven other foods had nominally significant association (0.0008 < P < 0.05) – wine, soft drink, fish, poultry, tomato and self-reported added sugar were urate-raising, and cake, apple, peach, banana and cold cereal were urate-lowering.

Conclusion: This research represents the first diet-wide association study in serum urate which considers each food item separately. Several of the novel associations may be confounded by correlations with other foodstuffs, or represent differences in overall diet. However this work represents an unbiased and inclusive understanding of dietary factors influencing urate levels.

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/diet-wide-association-study-of-serum-urate-levels-in-13782-individuals-of-european-ancestry/