New research suggests the risk of acute gout is almost two times higher during the night or early morning than it is during the day.
The risk remained the same even in people who did not consume alcohol or had low purine intake in the 24 hours before the attack occurred, a news release reported.
Acute gout is caused by the crystallization of uric acid.
Gout attacks are triggered by crystallization of uric acid within the joints. These attacks are believed to be some of the most painful events experienced by humans. Uric acid is produced when the body breaks down purines, which can be found in organ meat, seafood and alcohol.
"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," said lead author Dr. Hyon Choi, currently at Massachusetts General Hospital/Harvard Medical School (formerly at Boston University School of Medicine). "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."
To make their findings, researchers looked at 724 gout patients who were followed on the internet for about a year. The patients were of an average age of 54 and were primarily white men who were college educated.
Over the course of the study, the participants suffered 1,433 gout attacks: "733 in the overnight hours (midnight to 7:59 a.m.), 310 in the daytime (8:00 a.m. to 2:59 p.m.), and 390 in the evening (3:00 p.m. to 11:59 p.m.) during the one-year study period," the news release reported. This meant that the risk of flare up was 2.4 times higher overnight and 1.3 times higher than they were during the day.
"Our findings provide the first prospective evidence that the risk of gout flares is higher during the night and early morning hours than during the day," Choi said. "As a result of our study, prophylactic measures that prevent gout flares, especially at night, may be more effective."
The findings were published in a recent edition of the journal Arthritis & Rheumatology.
