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Both genetic variation in ATP-binding cassette sub-family G member 2 ( ABCG2 ) and intake of fructose-containing beverages are major risk factors for hyperuricemia and gout. This study aimed to test the hypothesis that the  ABCG2  gout risk allele 141 K promotes the hyperuricaemic response to fructose loading.    Methods  Healthy volunteers (n = 74) provided serum and urine samples immediately before and 30, 60, 120 and 180 minutes after ingesting a 64 g fructose solution. Data were analyzed based on the presence or absence of the  ABCG2  141 K gout risk allele.    Results  The 141 K risk allele was present in 23 participants (31%). Overall, serum urate (SU) concentrations during the fructose load were similar in those with and without the 141 K allele ( P  SNP  = 0.15). However, the 141 K allele was associated with a smaller increase in SU following fructose intake ( P  SNP  <0.0001). Those with the 141 K allele also had a smaller increase in serum glucose following the fructose load ( P  SNP  = 0.002). Higher fractional excretion of uric acid (FEUA) at baseline and throughout the fructose load was observed in those with the 141 K risk allele ( P  SNP  <0.0001). However, the change in FEUA in response to fructose was not different in those with and without the 141 K risk allele ( P  SNP  = 0.39). The 141 K allele effects on serum urate and glucose were more pronounced in Polynesian participants and in those with a body mass index ≥25 kg/m 2 .    Conclusions  In contrast to the predicted responses for a hyperuricemia/gout risk allele, the 141 K allele is associated with smaller increases in SU and higher FEUA following a fructose load. The results suggest that  ABCG2  interacts with extra-renal metabolic pathways in a complex manner to regulate SU and gout risk.    Clinical Trials Registration  The study was registered by the Australian Clinical Trials Registry ( ACTRN12610001036000 ).

Influence of the ABCG2 gout risk 141 K allele on urate metabolism during a fructose challenge