Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts [评估饮食对血清尿酸盐水平的广泛影响：基于人群队列的荟萃分析]

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BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k3951 (Published 10 October 2018)
Cite this as: BMJ 2018;363:k3951

Authors
Tanya J Major, Ruth K Topless, Nicola Dalbeth, Tony R Merriman

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.