以前关于饮酒和痛风发生的研究大多包括男性或结合了两性，而饮酒和痛风之间的性别特异性关系知之甚少。这项前瞻性队列研究纳入了英国生物银行的 401128 名年龄在 37 岁至 73 岁之间的参与者，他们在基线时（2006-2010 年）没有痛风。对参与者进行随访至 2021 年 12 月 31 日，并在 2023 年 8 月至 2024 年 6 月期间对数据进行分析。基于问卷调查的总酒精和特定酒精饮料的消费量。结果是痛风事件，通过医院记录确定。使用多变量 Cox 比例风险回归模型来估计与饮酒相关的痛风事件的性别特异性风险比 (HR) 和 95% CI，特别考虑反向因果偏倚。主要分析包括 179828 名男性（平均 [SD ] 年龄，56.0 [8.2] 岁）和 221300 名女性（平均 [SD] 年龄，56.0 [8.0] 岁）。目前饮酒的男性患痛风的风险高于从不饮酒的男性（HR，1.69；95% CI，1.30-2.18），但女性则不然（HR，0.83；95% CI，0.67-1.03）。在当前饮酒者中，无论男女，较高的总饮酒量与较高的痛风风险相关，且男性比女性更显着（男性：HR，2.05 [95% CI，1.84-2.30]；女性：HR，1.34 [95% CI，1.12-1.61]）。特定酒精饮料消费中最明显的性别差异是啤酒或苹果酒（男性：平均 [SD]，每周 4.2 [4.8] 品脱；女性：平均 [SD]，每周 0.4 [1.1] 品脱）。无论男女，饮用香槟或白葡萄酒、啤酒或苹果酒以及烈酒均与较高的痛风风险相关，其中每天每 1 品脱啤酒或苹果酒的关联性最强（男性：HR，1.60 [95% CI， 1.53-1.67]；女性：HR，1.62 [95% CI，1.02-2.57]）。在对其他酒精饮料进行调整并排除因健康原因减少饮酒、自我报告健康状况不佳或患有心血管疾病、癌症或肾衰竭的个体后，轻度至中度饮用特定酒精饮料与痛风之间的一些负相关被消除在基线时，或在随访的前 2 年内出现痛风。在这项队列研究中，多种特定酒精饮料的较高消费量与男女患痛风的较高风险相关。总饮酒量的性别相关性可能与男性和女性饮酒类型的差异有关。

Previous studies on alcohol consumption and incident gout have mostly included men or combined both sexes, and the sex-specific associations between alcohol consumption and gout are poorly understood.To evaluate the consumption of total and specific alcoholic beverages in association with incident gout in men and women.This prospective cohort study included 401 128 participants in the UK Biobank aged 37 to 73 years who were free of gout at baseline (2006-2010). Participants were followed up through December 31, 2021, and data were analyzed between August 2023 and June 2024.Questionnaire-based consumption of total alcohol and specific alcoholic beverages.The outcome was incident gout, identified using hospital records. Multivariable Cox proportional hazards regression models were used to estimate sex-specific hazard ratios (HRs) and 95% CIs of incident gout associated with alcohol consumption, with a particular consideration of reverse causation bias.The main analysis included 179 828 men (mean [SD] age, 56.0 [8.2] years) and 221 300 women (mean [SD] age, 56.0 [8.0] years). Current drinkers showed a higher risk of gout than never drinkers among men (HR, 1.69; 95% CI, 1.30-2.18) but not among women (HR, 0.83; 95% CI, 0.67-1.03). Among current drinkers, higher total alcohol consumption was associated with a higher risk of gout among both sexes and more strongly among men than women (men: HR, 2.05 [95% CI, 1.84-2.30]; women: HR, 1.34 [95% CI, 1.12-1.61]). The most evident sex difference in the consumption of specific alcoholic beverages was observed for beer or cider (men: mean [SD], 4.2 [4.8] pints per week; women: mean [SD], 0.4 [1.1] pints per week). Consumption of champagne or white wine, beer or cider, and spirits each was associated with a higher risk of gout among both sexes, with beer or cider showing the strongest association per 1 pint per day (men: HR, 1.60 [95% CI, 1.53-1.67]; women: HR, 1.62 [95% CI, 1.02-2.57]). Some inverse associations between light to moderate consumption of specific alcoholic beverages and gout were eliminated after adjusting for other alcoholic beverages and excluding individuals who had reduced alcohol consumption for health reasons, self-reported poor health, or had cardiovascular disease, cancer, or kidney failure at baseline, or developed gout within the first 2 years of follow-up.In this cohort study, higher consumption of several specific alcoholic beverages was associated with a higher risk of gout among both sexes. The sex-specific associations for total alcohol consumption may be associated with differences between men and women in the types of alcohol consumed.