Purine-rich foods, dairy and protein intake, and the risk of gout in men.

Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G.

Rheumatology Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA. hchoi@partners.org

BACKGROUND: Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, the possibility that the consumption of dairy products has a role in protecting against gout has been raised by metabolic studies. We prospectively investigated the association of these dietary factors with new cases of gout. METHODS: Over a 12-year period, we prospectively examined the relationship between purported dietary risk factors and new cases of gout among 47,150 men who had no history of gout at base line. We used a supplementary questionnaire to ascertain whether participants met the American College of Rheumatology survey criteria for gout. Diet was assessed every four years by means of a food-frequency questionnaire. RESULTS: During the 12 years of the study, we documented 730 confirmed new cases of gout. The multivariate relative risk of gout among men in the highest quintile of meat intake, as compared with those in the lowest quintile, was 1.41 (95 percent confidence interval, 1.07 to 1.86; P for trend = 0.02), and the corresponding relative risk associated with seafood intake was 1.51 (95 percent confidence interval, 1.17 to 1.95; P for trend = 0.02). In contrast, the incidence of gout decreased with increasing intake of dairy products; the multivariate relative risk among men in the highest quintile, as compared with those in the lowest quintile, was 0.56 (95 percent confidence interval, 0.42 to 0.74; P for trend <0.001). The level of consumption of purine-rich vegetables and the total protein intake were not associated with an increased risk of gout. CONCLUSIONS: Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. Copyright 2004 Massachusetts Medical Society PMID: 15014182 [PubMed - indexed for MEDLINE]

Fonte: Pubmed - The New England Journal of Medicine, Volume 350:1093-1103, March 11, 2004, Number 11.

Full text: http://content.nejm.org/cgi/content/full/350/11/1093?ijkey=6b7ab6dd368c83ce1100d25bdfef63ef055f0a59

Tophaceous gout in a patient with rheumatoid arthritis.

Baker DL, Stroup JS, Gilstrap CA.

Center for Health Sciences at the Oklahoma State University in Tulsa, Tulsa, OK, USA.
Chronic gout and rheumatoid arthritis are common medical manifestations with debilitating effects on patients. However, these conditions are not typically identified concomitantly and can be hard to distinguish from one another. We report a rare case of a 50-year-old white woman with a history of chronic gout and rheumatoid arthritis who presented with intradermal tophaceous gout. Physical examination and laboratory results are described.

Reference:
- Pubmed: JAOA • Vol 107 • No 12 • December 2007 • 554-556

Full text: http://www.jaoa.org/cgi/content/full/107/12/554?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Tophaceous+gout+in+a+patient+with+rheumatoid+arthritis&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

palavra em ingês: Gout