SAT0408 BODY FAT MEDIATES THE CORRELATION BETWEEN FRUCTOSE-CONTAINING BEVERAGES CONSUMPTION AND SERUM URIC ACID IN MALE GOUT PATIENTS
Authors: LI Qianhua, Lijuan Yang, Yan-Hui Xu, Chao Deng, Jinjian Liang, Jianzi Lin, Lefeng Chen, Lie Dai
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Fructose-containing beverages (FCB) consumption has been recognized as a promoter of hyperuricemia and gout in recent years. FCB consumption also contributes to the development of obesity which is an important risk factor of gout. However, data about the associations among FCB consumption, obesity and the level of serum uric acid (sUA) is limited. <h3>Objectives:</h3> To investigate the associations among FCB consumption, obesity and sUA level in gout patients. <h3>Methods:</h3> Consecutive gout patients who fulfilled the 2016 ACR/EULAR classification criteria were recruited. Demographic information, clinical characteristics and comorbidities of gout were collected. A 10-items food frequency questionnaire was developed which included alcohol, red meat, animal offal, seafood, hotpot, slow-cooking soup, FCB, tea, coffee and milk/milk products. Patients were asked to report the average consumption frequency over the one year prior to the first gout attack. Body composition was assessed by bioelectric impedance analysis and overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. <h3>Results:</h3> 1) Among 331 recruited gout patients, 96.1% were male, so only male patients were further analyzed. The median age of male patients was 37.5 (30, 49) years and median sUA was 9.5 (7.8, 10.5) mg/dl with 18.9% presented tophi. The mean BF% was 25.6±6.2% and 54.7% male patients were overfat. The prevalence of hypertension, diabetes, dyslipidemia, metabolic syndrome and fatty liver were 34.6%, 8.5%, 62.9%, 44.3% and 46.9% respectively. 2) There were no significant difference of food intake frequency between overfat patients and normal fat patients. Spearman correlation analysis results showed that FCB consumption was positively correlated with BF% (<i>r</i>=0.176,<i> P</i>=0.002), while milk/milk products consumption was negatively correlated with BF% (<i>r</i>=-0.117, <i>P</i>=0.038). After adjusted by age, duration, family history, eGFR, hypertension, diabetes mellitus, dyslipidemia, metabolic syndrome, fatty liver and the other nine dietary factors, multivariable linear regression showed that FCB consumption was positively correlated with BF% (compared with &lt;1 time/w, 3-4 times/w: coefficient <i>β</i>=2.4619, 95%<i>CI</i> 0.3580∼4.5657, <i>P</i>=0.022; 4 times/w: coefficient <i>β</i>=2.6696, 95%<i>CI</i> 0.8266∼4.5726, <i>P</i>=0.0049), and BF% was positively correlated with sUA (coefficient <i>β</i>=0.0784, 95%<i>CI</i> 0.0328∼0.1239, <i>P</i>&lt;0.001). However, FCB consumption was not correlated with sUA after adjusted by above confounders and BF% (<i>P</i>=0.079). 3) Further mediation analysis were performed to evaluate whether BF% mediated the correlation between FCB consumption and sUA. After adjusted by the confounding factors mentioned above, the total effect of FCB consumption on sUA was significant (compared with &lt;1 time/w, &gt;4 times/w: coefficient <i>β</i>=0.8813, 95%<i>CI</i> 0.1457∼1.6169, <i>P</i>=0.019). BF% produced indirect effect on the correlation between FCB consumption and sUA (compared with &lt;1 time/w, &gt;4 times/w: indirect effect coefficient <i>β</i>=0.2115, 95%<i>CI</i> 0.0453∼0.4032). <h3>Conclusion:</h3> Our data show that body fat mediates the correlation between FCB consumption and sUA in male gout patients, which imply the importance of body composition assessment. <h3>Acknowledgement:</h3> The present study was supported by Guangdong Natural Science Foundation, China (Grant no. 2014A030310086) to Qian-Hua Li. <h3>Disclosure of Interests:</h3> None declared