A new study has found that the risk of acute gout attack is almost double during the night or early morning hours than it is during the daytime.
The nocturnal attacks persist even among those who did not consume alcohol and had a low amount of purine intake during the 24 hours prior to the gout attack.
The body produces uric acid from the process of breaking down purines – natural substances in cells in the body and in most foods. High purine levels are found in organ meat, seafood and alcohol (yeast).
Acute gout flares are triggered by the crystallisation of uric acid within the joints, and experts believe these flares are “among the most painful events experienced by humans”.
“It is speculated that lower body temperature, night-time dehydration, or a nocturnal dip of cortisol levels may contribute to the risk of gout attacks at night,” said lead author Hyon Choi of the Massachusetts General Hospital and the Harvard Medical School in the US.
The research team recruited 724 gout patients, who were followed for one year via the internet.
Findings indicate that participants experienced 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 risk of a gout flare was 2.4 times higher overnight and 1.3 times higher in the evening compared to daytime hours.
“As a result of our study, prophylactic measures that prevent gout flares, especially at night, may be more effective,” the researchers said.
Furthermore, researchers found that this risk persisted even among those with no alcohol intake and low purine intake during the 24 hours prior to the gout attack.
The study was published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR).