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Gout Genetics vs Diet — SCE Rheumatology MCQ

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EasyCrystal ArthropathyGout Genetics vs DietSCE Rheumatology

A 40-year-old man with newly diagnosed gout believes that his diet alone caused the condition. Which comparison best reflects population evidence on the contributions of measured dietary patterns and inherited common genetic variation to variance in serum urate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Dietary-pattern scores no more than 0.3%; common genetic variation approximately 24%

Explanation lettering: D = shown as A · E = shown as B · B = shown as D · A = shown as E

D is correct. In a meta-analysis of 16,760 adults of European ancestry, each assessed dietary-pattern score explained no more than 0.3% of variance in serum urate, whereas common genome-wide genetic variation explained 23.9%. Thus, diet is not the sole or predominant population determinant of serum urate. Options A and C substantially overstate the contribution of measured dietary patterns, with C reversing the observed relationship. B incorrectly assigns no contribution to genetic variation, while E makes diet the dominant determinant without evidential support. These population estimates do not prove the cause of gout in an individual or imply that lifestyle is irrelevant. NICE advises a healthy balanced diet and addressing excess weight and excessive alcohol, but notes insufficient evidence that any specific diet prevents flares or lowers serum urate.

Reference: Major TJ, Topless RK, Dalbeth N, Merriman TR. Evaluation of the diet wide contribution to serum urate levels: meta-analysis of population based cohorts. BMJ. 2018;363:k3951. https://pubmed.ncbi.nlm.nih.gov/30305269/