Why does excessive alcohol consumption often lead to hyperuricemia and gout?
The quantity of alcohol consumption strongly correlates with the risk of developing gout. Consuming over 30 to 50 g of alcohol a day (three to four beers, glasses of wine, or liquor shots) increases gout risk by 2 to 2.5-fold compared with someone who does not consume alcohol. Alcohol consumption increases urate synthesis by accelerating the hepatic degradation of ATP. Alcohol consumption is also associated with lactate production, which further reduces renal urate excretion. In addition to alcohol content, beer contains a substantial amount of the purine guanosine and confers a >2-fold risk of gout over liquor. Moderate wine consumption does not appear to increase serum urate or gout risk. Recent data suggests that among those with established gout, episodic consumption of all alcohol types (wine, beer, and liquor) increases the risk of recurrent flare in a dose-dependent fashion.
