World Gout Day is celebrated on April 20 every year. This day also has its special meaning, because "420" is the cut-off value for diagnosing hyperuricemia. Clinical tests show that if the uric acid value is higher than 420 μmol/L in adult males and higher than 360 μmol/L in adult females, hyperuricemia can be diagnosed.
Bo Sun is the director of the Department of Endocrinology/Pediatric Endocrinology, Genetics and Metabolism of Gansu Provincial Central Hospital (Gansu Provincial Maternal and Child Health Hospital).
"Hyperuricemia has become the 'fourth highest' after hypertension, hyperlipidemia, and hyperglycemia. Sun Bo, director of the Department of Endocrinology/Pediatric Endocrinology, Genetics and Metabolism of Gansu Provincial Central Hospital (Gansu Provincial Maternal and Child Health Hospital), said that epidemiological data show that the overall prevalence of hyperuricemia in mainland China is 13.3%, with about 177 million patients, and the overall incidence of gout is 1.1%, with about 14.66 million patients, "Gout has become the second largest metabolic disease after diabetes." ”
Hyperuricemia is a precursor to gout
Gout is a common joint disease characterized by hyperuricemia, recurrent acute arthritis, tophi formation, chronic arthritis, joint deformity, chronic interstitial nephritis and uric urinary tract stones caused by kidney involvement. It is often complicated by cardiovascular and cerebrovascular diseases and is life-threatening.
Many people believe that gout is caused by an excessive intake of purines in the diet, which leads to an increase in uric acid content, so the daily diet of gout patients is very strict. The latest research also shows that dietary factors do play a role in the onset of gout, but only 20% of them. High-purine foods such as organ meats, seafood, red meat, etc., as well as excessive intake of alcohol and fructose, may lead to increased uric acid production.
In addition to diet, what other factors will affect the occurrence and development of gout? Sun Bo said: There are many causes of gout, such as genetic factors, and gout has a certain genetic predisposition. People with a family history of gout are at higher risk, and in general, men are more likely to develop gout than women, and middle-aged and older people are also more likely to develop gout. This may be related to changes in male hormones, physiological functions and the decline of kidney function, long-term staying up late, drinking, high-sugar and high-fat diet and other bad lifestyle habits, may increase the risk of disease, such as hypertension, diabetes, hyperlipidemia and other chronic diseases, as well as obesity, heart disease and other cardiovascular diseases, may increase the risk of gout.
Is hyperuricemia gout? Of course not, but hyperuricemia is a precursor to gout. Sun Bo said that when people think of hyperuricemia, they usually think of gout first. Over time, many people will equate gout with hyperuricemia, thinking that only the appearance of gout symptoms means that they have hyperuricemia. "In fact, gout is only a clinical manifestation of hyperuricemia, and generally only when urate is deposited in the body tissues to form urate crystals, which accumulate in the joints, patients will develop gout. But its harm is far more than that, according to statistics, about 20% of hyperuricemia will have symptoms of gout, and the remaining 80% will have no symptoms, but it will also cause harm to the heart, kidneys and other important organs of the human body. ”
Many people find that the uric acid value in the blood test results is high during the physical examination, and they are diagnosed with hyperuricemia, but they do not feel pain, itching, or discomfort. This is also because everyone's situation is different, and the average person has an average uric acid increase for 5-10 years before gout symptoms may appear. Prior to this, although uric acid in the blood was high, the patient did not have any uncomfortable symptoms.
Patients with gout should not self-taper the drug
Patients with gout usually have severe swelling and pain in the big toe joint. Some netizens described the pain of gout, as if they were bitten by something, and even their skin hurt. In addition to the big toe, the dorsum of the foot, ankle, knee joint, etc., are also prone to gout, and it is relatively rare in the lower back and hip joints.
"The first step in an acute gout attack is to relieve pain quickly, and drug therapy is the most effective method, with non-steroidal anti-inflammatory drugs as the preferred drug for pain relief; Patients minimize activity and rest in bed to help reduce local pain. It should be reminded that when gout patients have "painless gout", they also need uric acid-lowering therapy, monitor blood uric acid levels, seek medical attention in time, diagnose and treat early, carry out standardized and effective treatment, and do not reduce or stop the drug by themselves.
Wouldn't you have gout if you controlled your diet? Not really. "Gout attacks are indeed directly related to diet, and often eating high-protein, high-purine foods can easily lead to an increase in purines in the body and induce gout. However, the purine ingestion in food only accounts for 20% of the human body, and only controlling the diet cannot fundamentally control the gout attack, and more importantly, it depends on whether the patient adheres to drug treatment. ”
People with gout should drink less or no fruit drinks
Do gout patients only need to check uric acid? Sun Bo said that not only uric acid should be checked, "It is generally recommended that patients who take uric acid-lowering drugs initially have an outpatient re-examination of uric acid and liver and kidney function after 2 weeks, and if there is no abnormality in the examination results, it can be extended to a re-examination once a month, and if the re-examination results are still normal, it can be extended to 2-3 months for re-examination." Patients need to check uric acid and liver and kidney function for at least 3 months, and patients with kidney stones and gout are recommended to recheck kidney ultrasound every 3-6 months to observe the changes in stones. ”
Among the measures to prevent the recurrence of gout, it is necessary to avoid eating high-purine foods (such as animal offal, seafood, red meat, etc.), and eat more vegetables, fruits and low-fat foods. At the same time, maintain adequate water intake to help flush out uric acid from the body.
It should be reminded that gout patients drink less or no carbonated drinks and fruit juices, "because fructose in fruit juice is the main culprit of repeated gout attacks, the decomposition of fructose in the body will directly produce uric acid, increasing the source of endogenous uric acid; "It is also necessary to say goodbye to honey, honey has a fructose content of more than 70%, and gout patients try to stay away. No drink can replace drinking water, drink more than 2000ml of water every day, a small amount of water many times, the water can fully go to the kidneys to form urine, and help uric acid excretion. You should drink plain water, or ordinary mineral water, distilled water. Soda has the effect of alkalizing urine, helping to alkalize urine while urinating, pay attention to drink uncarbonated and sugar-free soda.
In addition, in prevention, it is necessary to maintain a good lifestyle and avoid staying up late, drinking alcohol and overwork. Proper physical exercise to enhance physical fitness and improve blood circulation. Weight control, being overweight and obese can increase uric acid production and decrease uric acid excretion, so maintaining a healthy weight is an important measure to prevent gout. Blood uric acid tests and liver and kidney function tests should be done regularly.
Text丨Rushing News reporter Ouyang Haijie
