AB0923 DIETARY FACTORS AND TOPHI: A FOOD INTAKE FREQUENCY SURVEY IN CHINESE GOUT PATIENTS
Authors: Q. H. LI, Y. F. Bi, X. H. Lin, H. B. Wang, C. Y. Wu, C. Deng, J. D. MA, H. W. Lu, J. J. Liang, L. Dai
Journal: Annals of the Rheumatic Diseases (2020)

Background: Tophi is a cardinal sign of advanced gout. Risk factors of gout are also closely related to the formation of tophi, such as impaired kidney function and serum uric acid (sUA). Several dietary factors, such as alcohol, fructose-containing beverage, red meat, sea foods have been confirmed increasing the risk of gout. Diet patterns vary widely in different countries. Dietary factors’ association with tophi formation remain elusive in Chinese gout patients. Objectives: This study aimed to study whether dietary factors were risk factors for tophi. Methods: We recruited consecutive gout patients who fulfilled the 2015 Gout Classification Criteria of ACR/EULAR and collected demographic data, gout disease characteristics and comorbidities. Tophi was evaluated by physical examination and/or musculoskeletal ultrasound. All gout patients completed 10-items food intake frequency questionnaire which included red meat, animal offal, seafood, alcohol, fructose-containing beverages, milk and dairy products, coffee, hotpot, slow-cooking soup and tea. Patients were advised to report the average frequency of food consumption in the preceding year of first gout attack. Multivariate logistic regression analysis was performed to evaluate risk factors of tophi. Dependent variables were those met p values less than 0.1 on univariate analysis. Results: a)There were 682 gout patients recruited with 94% male, mean age 44±16 years, and median gout duration 4 (2,7) years. The mean sUA was 9.0±2.3mg/dl. Tophi presented in 166 (24.3%) patients with 31 (4.5%) patients diagnosed by ultrasound. In patients with gout duration &lt;3 years, 3~4.9 years, 5~9.9 years and ≥10 years, the prevalence of tophi were 6.7%, 19.4%, 38.8%, and 49.6%, respectively. b)Tophus patients were characterized by older age (48±16 vs. 42±15 years), longer gout duration [7(4, 10) vs. 3(1, 5) years], more ever involved joints [11(4, 24) vs. 3(2, 5)] and more flare times in the last year [11(4, 24) vs. 3(2, 6)]. For comorbidities, tophus patients presented higher prevalence of urolithiasis (36% vs. 23%), hypertension (54% vs.40%,) and diabetes (20% vs. 11%) but less hypertriglyceridemia (19% vs. 32%, all P&lt;0.05). c)Compared with patients without tophi, tophus gout patients consumed more red meat (&gt;300g/d: 12% vs. 6%), seafood (&gt;2 times/w: 18% vs.13%), hotpot (≥1 time/w: 17% vs. 10%) and alcohol (&gt;84g/d: 23% vs. 9%). d)Dependent variables of multivariate logistic regression analysis included age, gender, gout duration, diuretics, BMI, sUA, serum creatinine, urine pH, hypertriglyceridemia, hypertension, diabetes, coronary heart disease, urolithiasis, alcohol consumption, hotpot, red meat, and seafoods. Gout duration, sUA, serum creatinine and urine pH were positively correlated with tophi, while hypertriglyceridemia was negatively associated with tophi. For dietary factors, heavy alcohol consumption (&gt; 84g/ day vs. &lt; 1g/ day OR=2.624, 95%CI: 1.437-4.793) and hotpot (≥ 1 time/w vs. &lt;1 time/w, OR=2.164, 95%CI: 1.217-3.847) were positively correlated with tophi. Conclusion: Our data suggest tophi should not be ignored in gout patients with short duration. Heavy alcohol consumption and hotpot are associated with the formation of tophi. Disclosure of Interests: None declared