4.20 International Gout Day, answer 7 questions about gout at one time

April 20 every year is "World Gout Day", this is because when the serum uric acid level in the body is >420 μmol/L, it is hyperuricemia.

01Whatis gout and how is it related to hyperuricemia?

Hyperuricemia, usually defined as serum urate concentration >420 μmol/L (6.

In other words, hyperuricemia is not a risk factor for gout.

02Why do you get hyperuricemia and gout

Let's take a look at how uric acid is produced in the body

The source of purine in the human body is mainly from food and fat

The red uric acid pool in the picture is like a pool of flowing pool water.

If this balance is broken, the rate of uric acid production is much higher than the rate of metabolism, and the body will have "excessive" urate levels, which will lead to hyperuricemia

With the premise of hyperuricemia and some predisposing factors, urate crystals are formed and deposited in tissues such as joints, causing acute and/or chronic inflammatory responses

03What are the risk factors for hyperuricemia and gout?

Unmodifiable risk factors: male sex, old age, race and genetics

Modifiable risk factors: Obesity, alcoholic beverages (especially beer and distilled spirits), carbonated beverages and fruit juices high in fructose or sucrose, high blood pressure , use of thiazide or loop diuretics, chronic kidney disease, and some medications

04Does gout really come from eating?

⭐Low purine diet

For more than a century, dietary composition and size have been suspected as risk factors for gout, so many people have suggested that gout patients should be on a low-purine diet, but it is not

Although a low-purine diet can reduce daily uric acid urinary excretion by approximately 200-400 mg, the mean serum uric acid concentration is only reduced by approximately 1 mg/dL (59 μmol/L), and a purine (and protein)-restricted diet is unhealthy and palatable.

In conclusion, a high-purine diet alone does not cause gout in healthy people.

⭐High protein

Clinical trials have found that eating more meat and seafood can significantly increase the risk of new gout, but it has not been seen to adversely affect patients with diagnosed gout

The source of protein is important because studies in Asian populations have found that the intake of soy and other legumes reduces the risk of new gout

⭐ Alcohol

Studies have shown that beer or spirits increase the risk of new gout, and beer, spirits, and wine all increase the risk of gout attacks in people who have already been diagnosed with gout

⭐Carbohydrates

In recent years, high intake of sugar (fructose, sucrose) has been found to be a new risk factor for gout
.

A genetically determined alteration in renal function of the uric acid/glucose/fructose transporter (SLC2A9) was identified in people already suffering from gout, which contributes to hyperuricemia following sucrose intake
.
Another study found that fructose intake increases uric acid production and reduces renal uric acid excretion
.

For other content, please refer to the recommended articles at the end of the article
.

05Can a low-purine diet treat gout?

As mentioned above: a low-purine diet has little change in blood uric acid concentration, and can lead to an imbalance in the intake of nutrients in the body
.
Therefore, it is impossible to control uric acid by only relying on a "low-purine diet"
.

Systemic uric acid-lowering therapy is still required for patients with gout
.

06Is it good to take painkillers when you have a gout attack?

Pain relievers are often referred to by patients as non-steroidal anti-inflammatory drugs
.
After eating, it can quickly and effectively relieve inflammation and reduce the pain of patients
.
But this is a palliative approach
.
You can't use "pain or not" as an indicator of "good or bad" for your disease
.
Although it no longer hurts, the uric acid in my body has not dropped, and it will happen again in the future, and it will only hurt more and more every time, eventually delaying the treatment
.
Not only unsightly tophi grows, but also damage to organs such as kidneys
.

07What should I do if I have gout?

⭐Standardized treatment

Once the diagnosis is confirmed, the treatment should be standardized as soon as possible, respect the doctor's advice, take the medicine on time and according to the dosage, follow up regularly, do not reduce or stop the medicine arbitrarily, actively cooperate with the doctor to formulate a treatment plan, and keep the uric acid level at an ideal level for a long time
.
 

⭐ Reasonable diet

Let 's take a look at what the guide has to say about diet
.

Guidelines for primary diagnosis and treatment of gout and hyperuricemia ( 2019 )

⭐Quit smoking and limit alcohol

Both beer and spirits (such as liquor, foreign wine, and rice wine) can increase the risk of gout attacks, with beer having a higher risk
.

⭐Drink more water

It is recommended that patients drink more than 2 000 ml of water per day, and can drink water, tea, and unsweetened coffee, and should avoid drinking sugary fruit juices and carbonated beverages
.

⭐Insist on exercising and lose weight healthily

Swimming, walking, and biking are options, but avoid excessive exercise
.
Especially for obese patients, weight loss should be scientifically
.
The ideal weight is to maintain a normal BMI (18.
5~24 kg/m2)
.

April 20 every year is "World Gout Day", this is because when the serum uric acid level in the body is >420 μmol/L, it is hyperuricemia.
Gout refers to the deposition of high blood uric acid in joints and tissues.
A group of diseases that cause multiple damages
.

01What  is gout and how is it related to hyperuricemia?

Hyperuricemia, usually defined as serum urate concentration >420 μmol/L (6.
8 mg/dL), is a common and necessary cause of gout
.
Not all patients with hyperuricemia will develop gout, but urate crystals are also required to form and deposit in tissues, causing acute and/or chronic inflammatory responses
.

In other words, hyperuricemia is not a risk factor for gout.
Data show that about ≥2/3 of hyperuricemia patients are asymptomatic, that is, they have never experienced gout attacks, tophi gout, acute or chronic hyperuricemia Hyperemia nephropathy or uric acid nephrolithiasis
.

02Why do you get hyperuricemia and gout

Let's take a look at how uric acid is produced in the body
.

The source of purine in the human body is mainly from food and fat
.
These purines are distributed in our blood and tissues
.
Finally, it is metabolized through the intestines and kidneys
.

The red uric acid pool in the picture is like a pool of flowing pool water.
Only when the "in" and "out" maintain a reasonable dynamic balance, the water (urate) in the pool will not overflow
.

If this balance is broken, the rate of uric acid production is much higher than the rate of metabolism, and the body will have "excessive" urate levels, which will lead to hyperuricemia
.

With the premise of hyperuricemia and some predisposing factors, urate crystals are formed and deposited in tissues such as joints, causing acute and/or chronic inflammatory responses
.
This is gout
.

03What are the risk factors for hyperuricemia and gout?

Unmodifiable risk factors: male sex, old age, race and genetics
.

Modifiable risk factors: Obesity, alcoholic beverages (especially beer and distilled spirits), carbonated beverages and fruit juices high in fructose or sucrose, high blood pressure , use of thiazide or loop diuretics, chronic kidney disease, and some medications
.

04Does gout really come from eating?

⭐Low purine diet

For more than a century, dietary composition and size have been suspected as risk factors for gout, so many people have suggested that gout patients should be on a low-purine diet, but it is not
.

Although a low-purine diet can reduce daily uric acid urinary excretion by approximately 200-400 mg, the mean serum uric acid concentration is only reduced by approximately 1 mg/dL (59 μmol/L), and a purine (and protein)-restricted diet is unhealthy and palatable.
The method is often ineffective for hyperuricemia and gout in patients with normal eating habits
.
Additionally, a prospective study found that consuming purine-rich vegetables and protein did not increase the risk of new gout
.

In conclusion, a high-purine diet alone does not cause gout in healthy people.
Similarly, for people who already suffer from gout, a low-purine diet has very limited changes in blood uric acid levels
.

⭐High protein

Clinical trials have found that eating more meat and seafood can significantly increase the risk of new gout, but it has not been seen to adversely affect patients with diagnosed gout
.

The source of protein is important because studies in Asian populations have found that the intake of soy and other legumes reduces the risk of new gout
.
Low-fat dairy products also reduce new gout attacks, but have not been shown to reduce gout flares in people who have already been diagnosed with gout
.

⭐ Alcohol

Studies have shown that beer or spirits increase the risk of new gout, and beer, spirits, and wine all increase the risk of gout attacks in people who have already been diagnosed with gout
.

⭐Carbohydrates

In recent years, high intake of sugar (fructose, sucrose) has been found to be a new risk factor for gout
.

A genetically determined alteration in renal function of the uric acid/glucose/fructose transporter (SLC2A9) was identified in people already suffering from gout, which contributes to hyperuricemia following sucrose intake
.
Another study found that fructose intake increases uric acid production and reduces renal uric acid excretion
.

For other content, please refer to the recommended articles at the end of the article
.

05Can a low-purine diet treat gout?

As mentioned above: a low-purine diet has little change in blood uric acid concentration, and can lead to an imbalance in the intake of nutrients in the body
.
Therefore, it is impossible to control uric acid by only relying on a "low-purine diet"
.

Systemic uric acid-lowering therapy is still required for patients with gout
.

06Is it good to take painkillers when you have a gout attack?

Pain relievers are often referred to by patients as non-steroidal anti-inflammatory drugs
.
After eating, it can quickly and effectively relieve inflammation and reduce the pain of patients
.
But this is a palliative approach
.
You can't use "pain or not" as an indicator of "good or bad" for your disease
.
Although it no longer hurts, the uric acid in my body has not dropped, and it will happen again in the future, and it will only hurt more and more every time, eventually delaying the treatment
.
Not only unsightly tophi grows, but also damage to organs such as kidneys
.

07What should I do if I have gout?

⭐Standardized treatment

Once the diagnosis is confirmed, the treatment should be standardized as soon as possible, respect the doctor's advice, take the medicine on time and according to the dosage, follow up regularly, do not reduce or stop the medicine arbitrarily, actively cooperate with the doctor to formulate a treatment plan, and keep the uric acid level at an ideal level for a long time
.
 

⭐ Reasonable diet

Let 's take a look at what the guide has to say about diet
.

Guidelines for primary diagnosis and treatment of gout and hyperuricemia ( 2019 )

⭐Quit smoking and limit alcohol

Both beer and spirits (such as liquor, foreign wine, and rice wine) can increase the risk of gout attacks, with beer having a higher risk
.

⭐Drink more water

It is recommended that patients drink more than 2 000 ml of water per day, and can drink water, tea, and unsweetened coffee, and should avoid drinking sugary fruit juices and carbonated beverages
.

⭐Insist on exercising and lose weight healthily

Swimming, walking, and biking are options, but avoid excessive exercise
.
Especially for obese patients, weight loss should be scientifically
.
The ideal weight is to maintain a normal BMI (18.
5~24 kg/m2)
.