Serum urate and its relationship with alcoholic beverage intake in men and women: findings from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort

Abstract

Objective: To investigate if beer, liquor (spirits), wine and total alcohol intakes have different associations with serum urate (SU) concentrations at different ages in a cohort of young men and women.

Methods: Data from 3123 participants at baseline and follow-up at 20 years were used, with balanced proportions of Caucasians and African Americans. The relationships of SU with categories of beer, liquor, wine and total alcohol intake referent to no intake were examined in sex-specific, cross-sectional analyses.

Results: Mean age (SD) at the beginning of follow-up was 25.1 (3.6) years. Compared with non-drinkers, significant associations between higher SU concentrations and greater beer intake were observed among men and women, with more pronounced and consistent associations for women. An association between greater liquor intake and higher SU concentrations was only seen for men at the year 20 evaluation. Wine intake was not associated with SU in either sex and total alcohol was associated with higher SU concentrations in both men and women. The magnitude of the associations between alcoholic beverages intake and SU was modest (≤0.03 mg/dl/alcoholic beverage serving).

Conclusion: An association between higher SU concentrations and greater beer intake was consistent and pronounced among women, but also present in men. Despite the small magnitude of the increases in SU associated with alcohol intake, clinical implications in conditions such as cardiovascular disease and gout in young adults who are moderate and heavy drinkers cannot be ruled out.

Figure 1

Multivariable adjusted predicted serum urate difference (in mg/dl) associated with categories of alcoholic beverage intake ((A) beer; (B) liquor (spirits); (C) wine; (D) total alcohol) and compared with the referent group of non-drinkers. Numbers above the error bars represent the exact serum urate difference with non-drinkers, numbers in parentheses represent the median alcoholic beverage intake for each category in servings per week. Years 0 and 20 multivariable modelling in both men and women was adjusted for age at inception, race, body mass index, serum creatinine, diuretic drug use and daily dairy intake. Antihypertensive drug use was added to all models in men and in women only at year 20. Meat and seafood intake was added to both men and women year 20 models and protein intake only for men at year 0. *One serving of beer is equal to a 12-ounce bottle (approximately 355 ml), one serving of liquor is equal to a 1.5 ounce shot (approximately 44 ml), one serving of wine is equal to a 5 ounce glass (approximately 148 ml), one serving of alcohol is equal to 17.24 ml. †Significantly different from non-drinkers (p<0.05).