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Yimaitong edited and sorted, please do not reprint
without authorization.
A recent study published in the journal Am J Clin Nutr.
(impact factor 8.
472) found that vitamin
88; 95% confidence interval [CI]: 0.
77-0.
99; P=0.
04).
Moreover, this effect was more pronounced
in participants with a BMI < 25kg/m2.
This suggests that vitamin C supplementation may be an effective strategy
to prevent gout.
Gout is a global disease that has attracted widespread attention
in recent years due to its increasing prevalence.
.
For a long time, urate-lowering drugs have been the main measure to prevent gout attacks, but some scholars believe that vitamin C can also be used to prevent the occurrence and attack
of gout.
There are short-term randomized trials that suggest that daily supplementation with 500 mg of vitamin C reduces serum uric acid
.
In this context, scholars from Beth Israel Deaconess Medical Center, one of the Harvard Medical School teaching hospitals in the United States, conducted a study to analyze the data of the Physicians' Health Study II (PHSII.
) trial to evaluate the effect of vitamin C supplementation on the incidence of gout, and also discussed the role of
The results of the study were recently published in the journal Am J Clin Nutr.
(impact factor 8.
472).
Research methods
This study was a post-hoc analysis
of the PHSII.
trial.
The PHSII.
trial was a randomized, double-blind, placebo-controlled factorial trial conducted at Brigham and Women's Hospital (the second largest affiliated teaching hospital at Harvard Medical School) from July 1997 to August 2007, involving male physicians aged ≥50 years, to assess the effects
of vitamin C (500 mg/day), vitamin E (400 IU every other day), and multivitamins on the risk of malignancy and
In this study, follow-up was up to 10 years until participants developed gout, died, ended the trial, or ended
with a vitamin intervention.
The primary outcome was that self-reports during follow-up indicated confirmed gout
.
Study results
The study included 14,641 randomly assigned male physicians with a mean age of 64±9 years
.
Effects of vitamin C on gout
During follow-up, the incidence was 8.
0 cases per 1000 person-years in the vitamin C group and 9.
1 cases per 1000 person-years
in the placebo group.
Vitamin C supplementation reduced new gout episodes by 12% (hazard ratio [HR]: 0.
88; 95% confidence interval [CI]: 0.
77 to 0.
99; P = 0.
04).
The cumulative incidence of gout is shown
in Figure 1.
Fig.
1 Effects of vitamin C and placebo on the incidence of gout
Of note, there is evidence that the effect of vitamin C on the onset of gout varies
with baseline
The incidence of BMI<25, 25~<30 and ≥30kg/m2 participants was 6.
6, 8.
8 and 15.
9 per 1000 person-years
, respectively.
The effect of vitamin C was most pronounced in participants with a BMI < 25 kg/m2, with a significantly lower risk of developing gout compared with placebo (HR: 0.
74 [95% CI: 0.
59, 0.
92]).
Effects of vitamin E on gout
There was no association between vitamin E supplementation and newly diagnosed gout (HR: 1.
05; 95% CI: 0.
92 to 1.
19).
Conclusion of the study
In this group of male physicians, vitamin C supplementation of 500 mg/day was found to be associated with a lower risk of new-onset gout, suggesting that vitamin C may prevent gout, while vitamin E supplementation has no effect
on preventing gout.
Elevated serum uric acid is one of the
most important risk factors for gout.
Observational studies have demonstrated an inverse correlation
between vitamin C intake and serum urate.
Animal models have also demonstrated that vitamin C lowers serum urate by inhibiting urate
synthesis.
In a stratified analysis, research data suggest that vitamin C may be more effective
in preventing gout in adults with normal BMIs.
The underlying mechanism of this observation is unclear and may reflect a dose-effect, i.
e.
, a dose of 500 mg/day is not sufficient for adults with a higher BMI
.
Observational evidence suggests that vitamin E is inversely associated with hyperuricemia, which lays the foundation
for the hypothesis that vitamin E may prevent gout.
This study tested this hypothesis in the context of randomized trials, but no association between vitamin E and gout risk was observed, suggesting that vitamin E supplementation may not be an effective strategy
for preventing gout.
References: Juraschek SP, Gaziano JM, Glynn RJ, et al.
Effects of vitamin C supplementation on gout risk: results from the Physicians' Health Study II trial[J].
Am J Clin Nutr.
2022 Sep 2; 116(3):812-819.
doi: 10.
1093/ajcn/nqac140.
PMID: 35575611; PMCID: PMC9437983.
