When it comes to diabetes, everyone is no stranger, it has long occupied the first place in the chinese people's metabolic disease disease, well-deserved "star disease".
However, in recent years, a new upstart has emerged, quietly pulling diabetes off the altar, leaping into a brother of chronic diseases (metabolic diseases) in the mainland, and forcefully renaming the "three highs" to "four highs", which is - hyperuricemia.
In 2017, a study published in scientific Report, a sub-journal of the internationally renowned journal Nature, showed that the prevalence of hyperuricemia in China rose from 1.4%[2] in the 1980s to 13% (18.5% for men and 8.0% for women)[1], equivalent to more than 170 million people suffering from it.
Source: Tencent Medical Dictionary Medical Illustration
Prevalence of hyperuricemia in China in 2016 (by sex/age)
At this point, the controversy of "who is a brother in metabolic diseases" is conclusive.
That's right, hyperuricemia has become the largest metabolic disease in mainland China!
When it comes to hyperuricemia, the first thing that comes to mind is gout.
It sounds like it doesn't matter, but the doctor always likes to pull them together.
So, are there any differences between the two of them? Okay, let's take a look.
Gout, figuratively speaking, is because the uric acid level is too high to dissolve in the blood, and countless "needles" (crystals) are precipitated in the blood, and these needles are stacked together, which leads to painful inflammation in and around the joint.
You can imagine how painful it is to have "needles" in the joints.
Source: Stand Cool Helo
Uric acid crystals in urine sediment
Conceptually, gout is bound to be a patient with hyperuricemia, but not all hyperuricemia will become gout, and gout is only a very small part of the population in hyperuricemia, accounting for about 5 to 12% [2].
But not people who get gout are necessarily higher than people who don't have gout, clinically, they will also encounter uric acid more than 300 gout, and patients with hyperuricemia whose uric acid has remained at more than 500 for more than ten years may not have gout.
So, remember the limits of two indicators: 420 μmol/L for men and 360 μmol/L for women, and pay attention beyond yourself!
Answer: Not really.
This is to say, the origin of uric acid.
That said, for a long time, people have been thinking that uric acid has no benefit except that it is too high to gout.
Here, we want to talk about a distant history to justify uric acid.
The latest research shows that throughout the long history of human evolution, uric acid can promote the accumulation of body fat in the presence of fructose in mammals, helping paleocepants (the old ancestors of humans) survive the cold food shortage period of the earth[4][5].
In the early Eocene, as the Earth's climate warmed, paleoclepits received more fruity foods (fruits) that were rich in ascorbic acid (Vc), a potent antioxidant that maintained antioxidant levels in primates.
But later, the earth's climate gradually became colder, the old ancestors of the fruit is less and less, in order to maintain enough antioxidant levels in the body, the uric acid in the body bravely stood out, took on the responsibility to compensate for the lack of Vc synthesis in the body, but also promoted the evolution of human beings.
Overall, the effects of uric acid include:
Inhibits the oxidation of unsaturated fatty acids and vitamin C and prevents thrombosis;
When the body is not enough vitamins, uric acid can replace it for antioxidant effects;
Inhibits the occurrence of cancer cells in the body, antioxidants and anti-cell mutations.
Therefore, uric acid has made outstanding contributions to the human body, do not kill with a pole.
However, nowadays, people eat better and better, and high uric acid is more and more common, which hurts people in the "invisible" and brings many harms to the human body.
Gout, once a royal disease, a disease of wealth, is a disease that increases with age. In ancient Western medicine, gout was also thought to be associated with fornication.
However, with the change of modern diet structure, more and more people lamented: "Without the emperor's life, but suffering from the emperor's disease."
Moreover, the rejuvenation of gout is getting more and more severe!
Recently, a variety show was exposed, and 23-year-old Guo Qilin also gloriously joined the TF-Boys (Gout Boys) boy group.
Source: Network
Even in the stage of hyperuricemia, the affected population is getting younger and younger.
For example, in Ningbo, the age of the sick population in 2006 was compared to that in 1998: males were 15 years younger, women were 10 years younger [2]...
According to a 2011-2013 admission physical examination of two universities in Kunming, the prevalence of hyperuricemia was 14.79% in boys and 1.04% in girls [6]. The name TF-Boys is really worthy of the name (boys are more common).
In order to remind more people to pay attention to the rejuvenation of hyperuricemia, the mainland has designated April 20 as "National Concern About Gout Day".
The theme of 2018 is: prevent gout, starting from teenagers.
Some diseases are "patriarchal", and hyperuricemia is a typical example.
As mentioned earlier, the prevalence of hyperuricemia in Chinese men has reached 18.5%, which is significantly higher than that of women in 8%[1]. Even among adolescent boys in a school in Kunming, the prevalence rate is 14.79%, and that of women is only 1.04%.[6]
Why is uric acid higher in men?
The reason may be related to the fact that men "produce more and excrete less uric acid", such as:
Men are significantly higher than women in terms of alcohol consumption, frequency, and high-purine diet.
Androgens inhibit the excretion of uric acid by the kidneys, resulting in an increase in uric acid levels in the body,
Androgens accelerate uric acid crystal formation and deposition, while estrogen promotes uric acid excretion.
Once men find that uric acid is higher than 420μmol/L, they should pay attention to it, on the one hand, they must reduce uric acid according to the doctor's recommended drugs, on the other hand, adjust their lifestyle, the following things are especially careful:
1. Limit alcohol, especially beer;
2. Non-smoking;
3. Pay attention to keep warm and avoid catching colds;
4. Increase the intake of fresh vegetables;
5. Maintain a regular diet and rest;
6. Reduce the intake of high-purine foods, such as animal offal, seafood, meat, etc.;
7. Reduce the intake of fructose-rich beverages, and check the composition of drinks before drinking;
8. Keep regular exercise, but try to choose gentle sports such as jogging and walking;
9. Control weight, body mass index (BMI) control within 25.
Someone said, "I have high uric acid, as long as there is no gout attack, it is fine; even if I have gout, it is only a little painful, no big problem." Remember, this idea is often dangerous!
This is because: hyperuricemia not only hurts the joints, but also quietly damages the heart, brain, kidneys and other important organs!
The most common, but also the most likely to attract the attention of patients, is gouty arthritis, once it occurs is an early warning signal, do not "good scars forget the pain".
An attack of gout is only the first step. The most common damaged organ after joints is the kidneys, where the serum uric acid content is persistently high, and urate crystals are deposited in the kidneys, forming stones.
Although, uric acid contributed to the evolution of upright walking in humans. However, the survival advantage provided by elevated uric acid has long been lost after the improvement of human living standards and changes in dietary structure.
Instead, a large number of prospective epidemiological studies have found that hyperuricemia is an independent risk factor for a variety of cardiovascular diseases!
The higher the uric acid exceeds the warning range, the greater the risk of stroke, diabetes, coronary heart disease, hypertension, heart failure, myocardial infarction, kidney disease and other diseases, and the worse the treatment effect.
Recipes are often seen online and circulate widely.
For example, patients with hyperuricemia cannot eat mushrooms and spinach because of the high content of purines.
Such words really make shiitake uncomfortable.
Is it really impossible to eat? This question is still answered from two aspects:
Mushrooms and spinach are not high-purine foods, fresh mushrooms are medium-to-purine foods,[7] and spinach is a less purine-containing food. The conclusion that shiitake mushrooms are high purine foods on the Internet refers to the purine content of dried shiitake mushrooms; and the fear of spinach stems from the rich oxalic acid content in spinach, which "collides" with uric acid.
A 2010 study published in the International Journal of Nutrition also showed that alkaline foods such as mushrooms and vegetables contribute to the dissolution and excretion of uric acid in the blood [8].
Therefore - mushrooms and vegetables can be eaten, and even have certain benefits for lowering uric acid!
Of course, when eating, it is recommended to blanch it.
Similarly, skim milk, with its high protein and low fat qualities, is also a quality drink for patients with hyperuricemia.
Conversely, some foods that are considered good things, such as honey, contain a lot of sugar, and like sugary drinks, the more uric acid they drink, the higher the uric acid!
Well, we have talked about this, and I will give you a small secret of the high uric acid diet by the way:
These foods, as soon as you eat uric acid, rise up
High-purine foods "Limited" eating is key
Body nutrition to keep up, high purine food must also be eaten, but be sure to limit the amount, including:
These foods are unlimited and add nutrients daily
In addition, the most important thing for patients with high uric acid is to pay attention to drinking more water, drinking at least 2000 ml of water every day, drinking some light tea and coffee appropriately, which can help urinate uric acid, but it should be noted that too strong coffee will increase the burden of the kidneys.
bibliography
[1] China Type 2 Diabetes Control Instruction (2017 edition), Diabetes Subcommittee of The Chinese Medical Association, 2018, 10(1): 4-67.
Chinese Medical Association Endocrinology Branch. Chinese expert consensus on the treatment of hyperuricemia and gout[J].Chinese Endocrine Metabolism Heterology, 2013, 29(11): 913-920.
[3] Cicerchi C, Li N, Kratzer J, et al. Uric acid-dependent inhibition of AMP kinase induces hepatic glucose production in diabetes and
starvation: evolutionary implications of the uricase loss in hominids. FASEB J. [Epub ahead of print]
[4] Johnson RJ, Andrews P. Fructose, uricase, and the back-to-Africa hypothesis. Evol Anthropol, 2010, 19(6):250-257.
[5] Lanaspa MA, Sanchez-Lozada LG, Choi YJ, et al. Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress:
potential role in fructose-dependent and -independent fatty liver.
[6] Wu J , Qiu L , Cheng X Q , et al. Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population[J]. Scientific Reports, 2017, 7(1):5456.
Li Jing, Li Jing. Epidemiological study of hyperuricemia[J]. Chinese Journal of Cardiovascular Diseases, 2016, 21(2):83-86.
Xiong Xiangling, Zhao Jiang, Chen Hongwei, et al. Analysis of health examination results of university freshmen from 2011 to 2013[J]. Modern Preventive Medicine, 2015, 42(20):3733-3735.
Sun Peilong, Wu Xueqian, Ji Peijun, et al. Detection of Purine Content of Shiitake Mushroom and Other Edible Mushrooms[J]. Science and Technology of Food Industry, 2000, 21(5):70-72.
[10] Kanbara A , Hakoda M , Seyama I . Urine alkalization facilitates uric acid excretion[J]. Nutrition Journal, 2010, 9(1):45.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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