Gout attack risk twice as high overnight than in the daytime

The risk of acute gout attacks is more than two times higher during the night or early morning hours than it is in the daytime, says research published in Arthritis & Rheumatology. And it doesn’t seem to be because of alcohol or meat consumption.
A total of 724 people with gout were followed for one year via the internet. They were asked to provide the date and hour that a gout attack occurred, and answered questions about their symptoms, medication, alcohol use and meat and seafood consumption during the 24 and 48 hours before the gout flare.
The participants were an average of 54 years of age, 89% were men and over half were college educated. During the gout flare or the time between attacks, 68% of the group drank alcohol, 29% took diuretics, 45% used allopurinol, 54% used nonsteroidal anti-inflammatory drugs (NSAIDs), and 26% took colchicine.
Over one year there were a total of 1,433 gout attacks: 733 attacks from midnight–7.59am; 310 from 8am – 2.59pm and 390 in the evening (3pm–11:59pm). The risk of a gout flare was 2.4 times higher overnight and 1.3 times higher in the evening compared to daytime hours.
This risk persisted even in those with no alcohol intake and low purine intake during the 24 hours before to the gout attack and were not affected by gender, age, body mass index, use of diuretics, gout medications or NSAIDs.
Acute gout flares are thought to be among the most painful events experienced by humans.
“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,” explains lead author Dr Hyon Choi. “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.”

Image credit: davejdoe

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