Ryoko (pseudonym), 26, accidentally fell in March and felt like she twisted her foot. I didn’t care, but after two weeks, I felt weakness in my lower limbs, and I walked as if “floating” on the sea.

One day, Ryoko had difficulty getting up, so with the help of her family, she went to the hospital for examination, but unexpectedlyin the thoracic spine The spinal canal was found full of “pebbles”. The doctor told him that these “tophi stones” compress the spinal cord, causing him to be unable to walk. If surgery is not performed in time, he may be paralyzed…

It turns out that Ryoko was born at the seaside and has three meals since childhood. Can’t live without seafood. In fact,when he was 19 years old, he was found to have high uric acid, and the doctor told him to pay attention to his diet, but he was young at that time and did not respond It’s okay to eat beer and seafood.

Last year, Ryoko’s an egg-sized tophi grew on her right foot, and there were similar lumps in her finger joints, I didn’t expect that today even the thoracic spine has accumulated dense “tophi”.

1. Why have the number of gout patients doubled in recent decades?

Published in Arthritis & Rheumatology, scholars from Iran, Australia, Canada, and the United Kingdom used database resources to analyze the prevalence of gout from 1990 to 2017, and found that Global gout patients have roughly doubled in 30 years.

According to relevant literature reports in 2016, the prevalence of gout in my country is 1%-3%, and the burden of gout is at a moderate level in the world. The average age of patients is about 1%. 48 years old.

Thirty or forty years ago, there were not many gout patients in our country. Why did the gout population grow so large in just a few decades?

The continuous increase of serum uric acid level is the main risk factor for gout, and the progression of hyperuricemia to gout may be the main reason. But does high uric acid necessarily cause gout?

Many gout patients will find that the blood uric acid level may be different each time they have gout. In most cases, it will be above 420 umol/L, but sometimes it is as high as 600 umol/L or more, and there is no gout.

So, while gout is associated with hyperuricemia,But gout attacks are not caused by a specific level of uric acid, but by a sharp change in the level of uric acid.

In addition, about 10%-15% of patients with hyperuricemia develop gout, but even asymptomatic patients with hyperuricemia can undergo CT examination. Urate deposition may also be found, and even osteolytic changes may occur, and joints may be significantly damaged, which is “subclinical gout”. It is equivalent to a transitional stage, and good management at this time can better eliminate gout in the budding stage.

In addition, living habits are the main practical reasons, and hyperuricemia or gout caused by failure to keep one’s mouth shut is not a minority.

Two, these 4 kinds of food, really need to eat less

< span>Gout not only needs to be controlled by drugs, but also the improvement of diet structure is also the key. ·

1, high-purine foods

long-term intake of high-purine foods means that the body Elevated uric acid causes the disease to recur and aggravate the disease.

According to dietary purine content, animal internal organs have the highest purine content, gout patients should be strictly Control their intake, followed bymost animal foods, including red meat, seafood, etc., should not be eaten too much.

Generally speaking, the average dietary intake of purine is 600-1000mg per day; in the acute stage of gout, control at 100-150mg per day; in the stable stage of gout, the daily dose is controlled at about 300mg.

2, wine

Alcohol metabolism will also increase the concentration of lactic acid in the blood, leading to the inhibition of renal tubular secretion, which is not conducive to the excretion of uric acid ; and alcohol itself contains purines, which also increase the concentration of uric acid.

3. Fructose beverages

With the in-depth study of gout diet, it is found that Sugar-sweetened beverages and juicesThe risk of causing gout is comparable to that of beer. Fructose in sugar-sweetened beverages can be metabolized in the body to promote uric acid synthesis, but also increase insulin resistance and hinder uric acid excretion.

4, coffee and strong tea

strong tea and coffee themselves do not contain high purines , but they can cause autonomic excitation, which may induce acute gout attacks. It is recommended that gout patients should reduce the intake of such drinks. enter.

In addition, prevent strenuous exercise or sudden cold, and increase the intake of fresh vegetables. Intake; drinking plenty of water (above 2000ml per day); weight control, regular exercise; regular diet and rest are all habits that gout patients should abide by.

Three, gout is not controlled, beware of your kidney problems

Kidney damage is the second most common comorbidity of hyperuricemia and gout , Why is gout and kidney damage related?

Published in BMJ OPEN, a new study from the University of Limerick in Ireland finds that uric acid levels are elevated , will cause glomerular hypertension, tubulointerstitial fibrosis, and cause kidney damage.

Recurrent gout attacks may cause chronic urate nephropathy, acute uric acid nephropathy, uric acid urolithiasis and other kidney diseases.

So timely treatment of gout is very important, according to2019 “Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout in China” divides gout patients into three categories and administers them according to different categories.

·asymptomatic hyperuricemia patients: start when blood uric acid ≥ 540 μmol/L Uric acid-lowering drug therapy; serum uric acid ≥ 480 μmol/L combined with any of the following complications: hypertension, diabetes, dyslipidemia, obesity, coronary heart disease, stroke, renal function damage, uric acid nephrolithiasis, etc.;

·non-acute gout patients: start uric acid-lowering drug therapy when serum uric acid ≥ 480 μmol/L; serum uric acid ≥ 420 μmol/L Combine any of the following cases.

Age less than 40 years old; gout attacks more than or equal to 2 times a year; suffering from tophi, kidney stones, chronic gouty arthritis, chronic kidney disease, hypertension, Diabetes, dyslipidemia, stroke, ischemic heart disease, heart failure and other diseases;

·patients with acute gout attack:< /strong>Uric acid-lowering drug therapy was started 2 to 4 weeks after the attack was completely resolved. Discontinuation of the medication is not recommended for patients with acute gout attacks who are taking medication.

The harm of gout is not only as simple as joint pain, it can also harm us other organs of the body. Therefore, all patients with hyperuricemia or gout, please pay attention, keep your mouth shut, and prevent attacks. #HealthTrue Knowledge Project#

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