Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts - PubMed (original) (raw)
Meta-Analysis
Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts
Tanya J Major et al. BMJ. 2018.
Abstract
Objective: To systematically test dietary components for association with serum urate levels and to evaluate the relative contributions of estimates of diet pattern and inherited genetic variants to population variance in serum urate levels.
Design: Meta-analysis of cross sectional data from the United States.
Data sources: Five cohort studies.
Review methods: 16 760 individuals of European ancestry (8414 men and 8346 women) from the US were included in analyses. Eligible individuals were aged over 18, without kidney disease or gout, and not taking urate lowering or diuretic drugs. All participants had serum urate measurements, dietary survey data, information on potential confounders (sex, age, body mass index, average daily calorie intake, years of education, exercise levels, smoking status, and menopausal status), and genome wide genotypes. The main outcome measures were average serum urate levels and variance in serum urate levels. β values (95% confidence intervals) and Bonferroni corrected P values from multivariable linear regression analyses, along with regression partial R2 values, were used to quantitate associations.
Results: Seven foods were associated with raised serum urate levels (beer, liquor, wine, potato, poultry, soft drinks, and meat (beef, pork, or lamb)) and eight foods were associated with reduced serum urate levels (eggs, peanuts, cold cereal, skim milk, cheese, brown bread, margarine, and non-citrus fruits) in the male, female, or full cohorts. Three diet scores, constructed on the basis of healthy diet guidelines, were inversely associated with serum urate levels and a fourth, data driven diet pattern positively associated with raised serum urate levels, but each explained ≤0.3% of variance in serum urate. In comparison, 23.9% of variance in serum urate levels was explained by common, genome wide single nucleotide variation.
Conclusion: In contrast with genetic contributions, diet explains very little variation in serum urate levels in the general population.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Conflict of interest statement
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi\_disclosure.pdf and declare: ND has received consulting fees, speaker fees, or grants from the following companies who have developed or marketed urate lowering drugs for management of gout: Takeda, Ardea Biosciences/AstraZeneca, Cymabay/Kowa, and Crealta/Horizon. TRM has received grants from Ardea Biosciences/AstraZeneca and Ironwood Pharmaceuticals.
Figures
Fig 1
Manhattan plot of −log10(P values) for 63 food items associated with serum urate levels. *Not all datasets were included in the analysis. The number of asterisks represents the number of datasets missing
Comment in
- The role of diet in serum urate concentration.
Watson L, Roddy E. Watson L, et al. BMJ. 2018 Oct 10;363:k4140. doi: 10.1136/bmj.k4140. BMJ. 2018. PMID: 30305276 No abstract available.
References
- Winnard D, Wright C, Jackson G, et al. Gout, diabetes and cardiovascular disease in the Aotearoa New Zealand adult population: co-prevalence and implications for clinical practice. N Z Med J 2013;126:53-64 - PubMed
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