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by Hyon K. Choi, MD, DrPH; Xiang Gao, MD, PhD; Gary Curhan, MD, ScD | 3/10/2009 8:46:35 AM
Vitamin C Intake and the Risk of Gout in Men Abstract A Prospective Study Background Several metabolic studies and a recent double-blind, placebo-controlled, randomized trial have shown that higher vitamin C intake significantly reduces serum uric acid levels. Yet the relation with risk of gout is unknown. Methods We prospectively examined, from1986 through 2006, the relation between vitamin C intake and risk of incident gout in 46 994 male participants with no history of gout at baseline. We used a supplementary questionnaire to ascertain the American College of Rheumatology criteria for gout. Vitamin C intake was assessed every 4 years through validated questionnaires. Results During the 20 years of follow-up, we documented 1317 confirmed incident cases of gout. Compared with men with vitamin C intake less than 250 mg/d, the multivariate relative risk (RR) of gout was 0.83 (95% confidence interval [CI], 0.71-0.97) for total vitamin C intake of 500 to 999 mg/d, 0.66 (0.52-0.86) for 1000 to 1499 mg/d, and 0.55 (0.38-0.80) for 1500 mg/d or greater (P < .001 for trend). The multivariate RR per 500-mg increase in total daily vitamin C intake was 0.83 (95% CI, 0.77-0.90). Compared with men who did not use supplemental vitamin C, the multivariate RR of gout was 0.66 (95% CI, 0.49-0.88) for supplemental vitamin C intake of 1000 to 1499 mg/d and 0.55 (0.36-0.86) for 1500 mg/d or greater (P < .001 for trend). Conclusions Higher vitamin C intake is independently associated with a lower risk of gout. Supplemental vitamin C intake may be beneficial in the prevention of gout. Authors Affiliations: Division of Rheumatology, Department of Medicine, Arthritis Research Centre of Canada, Vancouver General Hospital, University of British Columbia, Vancouver, Canada (Dr Choi); Channing Laboratory (Drs Choi, Gao, and Curhan) and Renal Division, Department of Medicine (Dr Curhan), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston (Drs Gao and Curhan). Dr Choi is now with the Rheumatology Section, Clinical Epidemiology Unit, Boston University School of Medicine, Boston. Arch Intern Med. 2009;169(5):502-507.