A recent journal published in Arthritis & Rheumatology by the Massachusetts General Hospital/Harvard Medical School shows that acute gout attacks occur two times more often during the night and early morning than during the day. The increased risk was seen even among patients with low purine intake in the 24 hours prior to an attack. Purines are specific chemical compounds found in some foods and are broken down into uric acids. A diet rich in purines from certain sources of food can raise uric acid levels in the body, sometimes leading to the onset of gout.
In an interview with HealthDay, study author Dr. Hyon Choi said: "It is speculated that lower body temperature, nighttime dehydration, or a nocturnal dip of cortisol levels may contribute to the risk of gout attacks at night. Despite the possibility of a nighttime link to gout, no study prior to our current investigation has looked at the association between gout attack risk and the time of day."
Gout is a form of arthritis which is caused by a build-up of uric acid in the body. Normally uric acid is processed by the kidneys and excreted through urine. In most people with gout, the kidneys do not excrete uric acid adequately while in a minority of people with gout, too much uric acid is produced. Chronically high levels of uric acid in the blood form crystals, which are then deposited in joints, and sometimes tendons and skin as well. These deposits can cause pain-often severe-and swelling in the affected area or areas.
The disease affects approximately 1 in 30 people-up to nine times more commonly in men than in women. It can strike at any age, but tends almost always to affect men after the age of 40 and women after menopause.
The study included more than 700 gout patients. Participants were mostly white, male and averaged at 54 years of age. Their health was monitored for a year and saw a total of almost 1,500 acute gout attacks. Seven hundred of these attacks occurred between midnight and 7:59 a.m.; 300 happened between 8 a.m. and 2:59 p.m.; and 400 occurred between 3 p.m. and 11:59 p.m.
A number of different groups of people are at higher risk of developing gout. A family history of gout increases the chances of developing gout, as do certain medical conditions like hypertension, diabetes, and arteriosclerosis (narrowing of the arteries).
Lifestyle factors like alcohol consumption-more than one drink a day for women and two for men (beer is particularly bad) and excessive consumption of certain types of food are thought to increase the risk of gout. Foods thought to increase the risks of gout include: red meat in excess, organ meats-for example liver, kidneys, brains and shellfish.
In conclusion, Choi believes a more effective research is one that explores the preventive measures that prevent gout flares, especially at night.