Effect of Dietary and Supplemental Omega‐3 Polyunsaturated Fatty Acids on Risk of Recurrent Gout Flares

摘要

Objective To determine the relationship between omega‐3 polyunsaturated fatty acid (n‐3 PUFA ) consumption (dietary or supplemental) and risk of gout flares. Methods We used data from the Boston University Online Gout Study, an internet‐based case‐crossover study conducted from February 2003 to January 2012. At the times of gout flares (hazard period) and during gout flare–free periods (control periods), participants completed questionnaires regarding exposures, including supplements and diet, during the preceding 48 hours. We examined the relationship of self‐reported n‐3 PUFA –rich supplements and fish intake with the risk of recurrent gout flares using conditional logistic regression, adjusting for total purine intake, diuretic use, and other urate‐lowering or flare prophylactic medications (allopurinol, nonsteroidal antiinflammatory drugs, or colchicine). Results Of the 724 participants, 85% met the 1977 American College of Rheumatology preliminary criteria for the classification of the acute arthritis of primary gout. Twenty‐two percent of the participants reported some form of n‐3 PUFA consumption (supplements, 4.6%; dietary fatty fish, 19%) in the 48 hours preceding a gout flare or flare‐free period. The adjusted odds ratios were 1.01 (95% confidence interval [95% CI ] 0.63–1.60; P = 0.98) for all 3 supplements combined and 0.74 (95% CI 0.54–0.99; P = 0.04) for consumption of ≥2 n‐3 PUFA –rich fish servings. Conclusion Dietary n‐3 PUFA –rich fish consumption, when adjusted for total purine intake, was associated with lower risk of recurrent gout flares, whereas n‐3 PUFA supplementation alone, as taken in a self‐directed manner, was not. Consumption of specific sources and adequate doses of n‐3 PUFA for gout flare prevention warrants further study in an adequately powered clinical trial.