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Fructose malabsorption in people with and without gout: A case-control study
Caitlin Batt1, Niamh Fanning1, Jill Drake2
1Department of Medicine, University of Otago, Christchurch, New Zealand.
Fructose malabsorption rates are similar in people with and without gout. Allopurinol treatment in gout patients may negate the need to restrict dietary fructose intake, as it inhibits serum urate increases.
Area of Science:
- Metabolic disorders
- Gastroenterology
- Dietary science
Background:
- High fructose consumption is linked to hyperuricemia and gout.
- Fructose malabsorption affects a significant portion of the population.
- Understanding the interplay between fructose, malabsorption, and gout is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of fructose malabsorption in individuals with and without gout.
- To investigate the impact of gout and fructose malabsorption on serum urate levels.
- To assess the effect of a fructose load on serum urate in gout patients, particularly those on allopurinol.
Main Methods:
- A case-control study involving 100 individuals with gout and 100 matched controls without gout.
- Fructose malabsorption was assessed using hydrogen and methane breath tests after a 35g fructose load.
- Serum urate response to fructose was measured in a subgroup over 240 minutes.
Main Results:
- No significant difference in fructose malabsorption rates was observed between gout patients (48%) and controls (52%).
- Gout patients exhibited significantly lower serum urate increases (iAUC0-240 and Cmax) after fructose load compared to controls.
- Allopurinol, used by 95% of gout cases, appeared to inhibit the serum urate response to fructose, with no difference seen between malabsorbers and normal absorbers.
Conclusions:
- Fructose malabsorption rates are comparable in individuals with and without gout.
- Allopurinol effectively mitigates the serum urate-elevating effect of dietary fructose in gout patients.
- Gout patients on allopurinol may not require strict dietary fructose restriction.
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