High uric acid can cause gout, so the lower the uric acid, the better?
Uric acid is the end product of human purine metabolism, the normal range of men is 149~416μmol/L, and the normal range of women is 89~357μmol/L (the reference value of different hospitals may be slightly different).
When uric acid is produced too much or uric acid is excreted decreased, it can lead to elevated uric acid.
Whether male or female, the blood uric acid level exceeds 420 μmol/L twice a day, which is called hyperuricemia.
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In recent years, the incidence of hyperuricemia in mainland China has increased year by year.
It is estimated that the number of people suffering from hyperuricemia in mainland China reaches 120 million.
If hyperuricemia is not effectively controlled, gout may develop.
Many people equate hyperuricemia with gout, which is not true.
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In fact, only 5%~12% of patients with hyperuricemia will suffer from gout.
Gout can only be diagnosed when hyperacidemia causes urate crystal deposition and there are clinical manifestations such as acute arthritis, tophi, or gouty nephropathy.
High uric acid is indeed harmful, but uric acid is not the lower the better, low uric acid is no less harmful than high uric acid.
Hypouricemia occurs when the level of uric acid in the blood is lower than normal.
Hypouricemia often leads to renal hypouricemia, easy to induce exercise-related acute kidney injury, which usually occurs within 6~12 hours after strenuous exercise, and patients will have severe abdominal pain and nausea.
Urinary tract stones are the most common comorbidities of renal hypouricemia, because of the low uric acid in the blood and more uric acid in the urine, it is easy to precipitate crystals in the urethra and form stones.
Uric acid urinary tract stones can cause renal colic, hematuria, urinary tract infection, and even obstruction of renal tubules, resulting in acute renal failure.
Studies have found that patients with hypouricemia are more likely to have cognitive deterioration, a higher risk of dementia, and a more complex mechanism of influence.
If the patient has memory loss, a high index of suspicion for hypouricemia should be exercised.
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Some scholars have also found that when the blood uric acid level ≤ 240μmol/L, the risk of cardiovascular diseases such as acute myocardial infarction, heart failure, and coronary heart disease increases.
Uric acid removes harmful reactive oxygen species and is one of the important antioxidants in plasma.
If uric acid levels are too low, it can lead to decreased antioxidant capacity, vascular endothelial dysfunction, and increased atherosclerosis, thereby increasing the risk of cardiovascular events.
Therefore, uric acid can not be too high, can not pursue too low, control within a reasonable range is the key.
Source| Family Medicine, Issue 19, October 2022
Editor| Zhang Wanbo
Proofreader| Zheng Ke
Second instance| Zhang Yue
Final judges| Liu Huiying Zhang Ruxian