Article Publish Status: FREE
Abstract Title:

Fructose intake and risk of gout and hyperuricemia: a systematic review and meta-analysis of prospective cohort studies.

Abstract Source:

BMJ Open. 2016 Oct 3 ;6(10):e013191. Epub 2016 Oct 3. PMID: 27697882

Abstract Author(s):

Joseph Jamnik, Sara Rehman, Sonia Blanco Mejia, Russell J de Souza, Tauseef A Khan, Lawrence A Leiter, Thomas M S Wolever, Cyril W C Kendall, David J A Jenkins, John L Sievenpiper

Article Affiliation:

Joseph Jamnik


BACKGROUND: The prevalence of hyperuricemia and gout has increased in recent decades. The role of dietary fructose in the development of these conditions remains unclear.

OBJECTIVE: To conduct a systematic review and meta-analysis of prospective cohort studies investigating the association fructose consumption with incident gout and hyperuricemia.

DESIGN: MEDLINE, EMBASE and the Cochrane Library were searched (through September 2015). We included prospective cohort studies that assessed fructose consumption and incident gout or hyperuricemia. 2 independent reviewers extracted relevant data and assessed study quality using the Newcastle-Ottawa Scale. We pooled natural-log transformed risk ratios (RRs) using the generic inverse variance method. Interstudy heterogeneity was assessed (Cochran Q statistic) and quantified (I(2) statistic). The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS: 2 studies involving 125 299 participants and 1533 cases of incident gout assessed the association between fructose consumption and incident gout over an average of 17 years of follow-up. No eligible studies assessed incident hyperuricemia as an outcome. Fructose consumption was associated with an increase in the riskof gout (RR=1.62, 95% CI 1.28 to 2.03, p<0.0001) with no evidence of interstudy heterogeneity (I(2)=0%, p=0.33) when comparing the highest (>11.8% to>11.9% total energy) and lowest (<6.9% to<7.5% total energy) quantiles of consumption.

LIMITATIONS: Despite a dose-response gradient, the overall quality of evidence as assessed by GRADE was low, due to indirectness. There were only two prospective cohort studies involving predominantly white health professionals that assessed incident gout, and none assessed hyperuricemia.

CONCLUSIONS: Fructose consumption was associated with an increased risk of developing gout in predominantly white health professionals. More prospective studies are necessary to understand better the role of fructose and its food sources in the development of gout and hyperuricemia.


Study Type : Meta Analysis, Review

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