Association Between Diet and Genetic Predisposition in Risk for Incident Gout Among Women

The Dietary Approaches to Stop Hypertension (DASH) diet is associated with lower risk for incident gout, and appears to be more significant among women with a genetic predisposition to gout, according to study results presented at the American College of Rheumatology (ACR) Convergence 2021, held virtually from November 3 to 10, 2021.

Although the DASH diet – a diet rich in vegetables, fruits, and whole grains – lowers serum urate and is associated with a lower risk for incident gout, limited data are available on the impact of the diet based on genetic risk.

The objective of the current study was to determine whether diet affects gout risk differently among genetically predisposed women.

Using data from 18,247 women aged older than 34 years from the prospective Nurses’ Health Study. Validated food frequency questionnaires were used to assess DASH and Western diet scores that were categorized into quintiles, with higher quintiles indicating higher adherence to these dietary patterns.

Using 114 serum urate single-nucleotide polymorphisms from the latest genome-wide association study, a genetic risk score was established, with a higher score indicating a higher genetic predisposition for hyperuricemia.

Overall, 481 women without a genetic predisposition and 859 women with a genetic predisposition self-reported a diagnosis of gout. At baseline, no difference was noted in the clinical gout risk factors between women with and without a genetic predisposition.

Among women without a genetic predisposition to gout, DASH diet was associated with lower risk for incident gout. Compared with the highest quintile of DASH diet, the relative risk for gout was 1.43, 1.48, 1.36 and 1.31 among individuals within the first, second, third and fourth quintile. Western diet was associated with increased risk for incident gout, with relative risk for quintiles 1 through 5 of 1.0, 1.18, 0.98, 1.20, and 1.58.

Among those with a genetic predisposition, the risk for gout compared with women without a genetic predisposition in the highest quintile of DASH diet, the risk for gout for quintiles 5 through 1 were 1.76, 1.72, 2.53, 3.11, and 2.79, respectively. The relative excess risk due to interaction when comparing the highest vs the lowest quintiles was 0.57 (95% CI, -0.02 to 1.17; P =.06). Western diet was associated with increased risk for incident gout, with relative risk for quintiles 1 through 5 of 1.93, 1.94, 2.01, 2.22, and 2.74.

“These data support the recent Global Burden of Disease (GBD) study’s recommendation for intensive dietary measures for gout prevention, especially in [women],” the researchers concluded.

Reference

Yokose C, McCormick N, Lu N, Joshi A, Choi HK. Does diet affect gout risk differently among genetically predisposed women?: prospective female cohort study findings over 34 years. Presented at: ACR Convergence 2021; November 3-10, 2021. Abstract 0991.