Is high uric acid just to prevent gout?

▎WuXi PharmaTech content team editors Many people believe that gout is "the number one pain in the world", which is enough to make people feel heartbroken and even doubt their lives
.

Therefore, after a gout attack, many patients will eat a long way to gain wisdom, and pay attention to control the intake of uric acid in the diet, lose weight, drink more water and so on in daily life
.

It is also possible that some people, although elevated uric acid is found during the physical examination, do not have any symptoms of joint pain, and usually do not pay special attention to diet and living habits
.

In fact, regardless of whether there is a gout attack, uric acid should be controlled within the ideal range
.

Moreover, in addition to preventing the occurrence and development of gout, it is also necessary to prevent the occurrence of related complications
.

Image source: The importance of 123RF to control uric acid We know that hyperuricemia refers to fasting serum uric acid (SUA) levels >420 μmol/L on two different days under a normal purine diet
.

Most patients with hyperuricemia are asymptomatic
.

Gout is a condition in which patients with hyperuricemia have acute inflammatory reactions in the body due to the crystals originally deposited in the joints due to various incentives
.

During a gout attack, people experience sudden pain, tenderness, redness, warmth, and swelling in the localized joint
.

Of course, joint pain is not necessarily a gout attack.
For details, please see: Joint pain is gout? These types of arthritis may also "follow" the progression of hyperuricemia and gout.
There are four pathophysiological stages: Development of hyperuricemia: Blood uric acid levels are poorly controlled and remain elevated for a long time
.

Urate crystal deposition: Approximately 25% of patients with hyperuricemia have urate crystal deposition, which can be confirmed by imaging
.

The appearance of urate crystal deposition is considered to be an important node in the development of gout
.

Gout attack: caused by acute inflammatory reaction of deposited crystals, the main triggers are high uric acid diet (drinking beer, eating skewers, eating a lot of animal offal, fish soup, broth, etc.
), joint damage, local temperature decrease, local pH decrease in value, fatigue,
etc.

Late stage of the disease characterized by tophi: recurrent gout, severe joint deformity, etc.
, which seriously affects daily life
.

Studies have shown that 13.
3% of people in China have hyperuricemia, but only 1.
1% have gout
.

Although hyperuricemia is the "only way" for the development of gout, a considerable number of patients with hyperuricemia will not develop gout
.

Studies have shown that even in people with severe hyperuricemia (≥600 µmol/L), less than half of them will develop gout within 15 years
.

However, it should be noted that elevated serum uric acid is an important risk factor for the development of gout, and the higher the serum uric acid, the greater the probability of gout attacks
.

Studies have confirmed that the incidence of gout is 30.
5% when blood uric acid is ≥600 μmol/L, and the incidence of gout is only 0.
6% when blood uric acid is less than 420 μmol/L
.

Therefore, it is clearly pointed out in the "Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout in China (2019)" that it is recommended that all patients with hyperuricemia and gout know and pay attention to the influencing factors of blood uric acid level for life, and always control the blood uric acid level within the ideal range.

.

The guidelines point out that controlling the blood uric acid level within 240-420 μmol/L can significantly reduce the frequency of gout attacks, prevent tophi formation, prevent bone destruction, reduce the risk of death and improve the quality of life of patients
.

Another study published in "The Lancet Rheumatology" (The Lancet Rheumatology) also re-emphasized that the control of serum uric acid is very important with or without symptoms
.

The results of the study showed that when the serum uric acid concentration continued to average <360 μmol/L, it could effectively reduce the risk of gout attacks in the following 1 year, and reduce the number of attacks
.

In addition, the harm of gout goes far beyond the local joints (such as feet, ankles, knees and other joints) with redness, swelling, heat and pain.
Hyperuricemia and gout are also independent risk factors for chronic kidney disease, hypertension, cardiovascular and cerebrovascular diseases, and diabetes.
, or an independent predictor of premature death
.

Therefore, actively intervening in hyperuricemia and controlling the uric acid level within the normal range can not only prevent the occurrence of gout, but also the key to avoid the occurrence of other diseases
.

If you want to know how to control uric acid, please see for details: These meats have more uric acid than seafood! Stay away from gout and eat like this Image source: 123RF The prevention of these complications is also important.
Gout is a complex metabolic and inflammatory disease
.

A lot of evidence shows that hyperuricemia and gout are systemic diseases involving multiple systems, which are often closely related to the occurrence and development of multiple diseases
.

In addition to joint symptoms, it is also a risk factor for the development of various diseases such as metabolic syndrome, type 2 diabetes, hypertension, cardiovascular disease, chronic kidney disease, kidney stones, osteoporosis, and sleep disorders
.

The following is a brief introduction to 4 common complications
.

01 Kidney stones Kidney stones are one of the most common complications of gout, affecting approximately one in five people with gout
.

This is because urate crystals may accumulate in the urethra of people with gout, promoting the formation of kidney stones
.

With kidney stones, people may experience the following symptoms: severe pain on the side and back under the ribs; pain when urinating; pink, red, or brown urine; pain that may radiate to the lower abdomen and groin
.

02Cardiovascular disease Gout causes inflammation of joints and other parts of the body, and inflammation is also a risk factor for cardiovascular disease, so gout and cardiovascular disease often co-occur
.

A study found that people with gout had a 15% increased risk of dying from cardiovascular disease or stroke compared with patients who had never had gout but had cardiovascular disease; people with gout had a 2-fold increased risk of dying from heart failure
.

Also, in patients with obstructive coronary artery disease, a history of gout is often associated with worse patient outcomes
.

Medication does not address the cardiovascular risk associated with gout, although it can be treated with medications for cardiovascular disease
.

Image source: 123RF03 Diabetes Studies have shown that patients with gout have a higher risk of developing diabetes than patients without gout, and this result is correlated with other known risk factors (high blood pressure, hyperlipidemia, etc.
) disease, etc.
) irrelevant
.

The researchers believe that gout may be independently associated with an increased risk of diabetes, and the association is significantly greater in women than in men
.

This may be due to persistent low-grade inflammation in gout patients, which may contribute to the development of diabetes
.

05Fractures Gout patients are more prone to osteopenia and osteoporosis, which increases the risk of fractures, especially in women
.

Studies have found that the overall fracture rate of people with gout is close to 23%, which is much higher than that of people without gout
.

According to the analysis of the study, gout and fractures may be related to three reasons: First, gout itself increases the risk of lower extremity and spine fractures
.

Second, hyperuricemia may cause severe acute arthritis, and the production of inflammatory markers may be associated with changes in bone density and resorption
.

Finally, uric acid itself has an effect on oxidative stress, which may initiate osteoclast activation, thereby affecting bone mass and increasing fracture risk
.

The researchers pointed out that the prevention and treatment of gout is of great significance to patients with osteoporosis
.

In addition, gout can seriously affect a patient's psychological and social health
.

If a patient's blood uric acid levels are poorly controlled, they may experience recurrent gout attacks, and chronic pain may lead to feelings of stress, anxiety, and depression
.

Furthermore, gout attacks can have a dramatic impact on a patient's daily life by causing severe pain, making it difficult to move around, perform daily tasks, and socialize
.

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Source: 123RF Reference [1] Nicola Dalbeth, et al.
, (2021).
Gout.
The Lancet, DOI: https://doi.
org/10.
1016/S0140- 6736(21)00569-9[2] Lisa K Stamp, Christopher Frampton, JasvinderA Singh, et al.
, (2021).
Association between serum urate and flares in people with gout and evidence for surrogate status: a secondary analysis of tworandomised controlled trials .
The Lancet Rheumatology.
DOI: https://doi.
org/10.
1016/S2665-9913(21)00319-2[3] 8 Gout Complications You Need to Know About.
Retrieved 07/03/19, FROM https:// creakyjoints.
org/about-arthritis/gout/gout-symptoms/gout-complications/ Disclaimer: The WuXi AppTec content team focuses on global biomedical health research progress
.

This article is for information exchange purposes only, and the views expressed in this article do not represent WuXi AppTec's position, nor do they represent WuXi AppTec's support or opposition to the views expressed in this article
.

This article is also not a treatment plan recommendation
.

For guidance on treatment options, please visit a regular hospital
.