Rates of fructose malabsorption in gout cases and non-gout controls in Christchurch, New Zealand

Abstract

Background: Gout is a common form of inflammatory arthritis caused by the precipitation of monosodium urate crystals in the joints. The prevalence of gout in New Zealand is 9.62% in Māori men and 5.12% in European men. Hyperuricaemia is a risk factor for gout and has been associated with fructose, a sugar found in fruit and sweeteners. Fructose malabsorption has a prevalence of 34% in healthy individuals. The aim of this case-control study is to observe whether there is an association between fructose malabsorption and gout. Method: Cases (n=65) were those with clinically diagnosed gout. Controls (n=65) were age and gender matched from the general population. Fructose malabsorption was measured in cases and controls using a breath test that measures gas products of the metabolism of fructose by bacteria in the gastrointestinal tract. Results: The rate of fructose malabsorption in cases was 49.2% and in controls was 53.8%. The odds of malabsorbing fructose in those with gout compared to those without was 0.82 (95%CI 0.41-1.67). Conclusion: There is no significant difference in rates of fructose malabsorption between gout cases and controls. Future studies are required to determine whether the effect of fructose load on serum urate is different between malabsorbers and absorbers in gout cases and those without gout. In future practice dietary advice for gout could be individualised based on absorption status, improving compliance.