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

MaryAnn Zhang, Yuqing Zhang, Robert Terkeltaub, Clara Chen, Tuhina Neogi
Arthritis & Rheumatology 2019 March 25

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 2003-2012. Participants completed questionnaires at times of gout flares (hazard periods) and during gout flare-free periods (control periods) regarding exposures (including supplements and diet) during the preceding 48 hours. We examined the relation of self-reported n-3 PUFA-rich supplements and fish intake to 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, non-steroidal anti-inflammatory drugs, colchicine).

RESULTS: Of the 724 participants, 85% met the 1977 Preliminary ACR classification criteria for acute gout. In the preceding 48 hours, 22% of participants reported some form of n-3 PUFA consumption (supplements: 4.6%; dietary fatty fish: 19%). The adjusted odds ratios (aOR) were 1.01 (95% CI, 0.63-1.60; p=0.98) for all three supplement types combined and 0.74 (95% CI, 0.54-0.99; p=0.04) for ≥2 n-3 PUFA-rich fish servings.

CONCLUSIONS: 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. This article is protected by copyright. All rights reserved.


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