With the improvement of living standards, people’s diet is becoming richer and richer, and many chronic diseases follow. In addition to the three highs that people are familiar with, there are also There is a more serious disease, which is also known as the fourth highest hyperuricemia.
There are more people suffering from high uric acid gout than diabetic people in my country. High uric acid is closely related to the intake of high purine food. This is because after high-purine foods enter the human body, they will be decomposed by nucleotides, and the final metabolite is uric acid.
For ordinary people, fresh vegetables are good for the body, but for people with high uric acid, some vegetables are high-purine vegetables If you want to effectively lower uric acid, you must eat less of these vegetables in your life.
01
First of all, how are purines produced?
There are two main ways to produce beautiful, the first is de novo synthesis, and the other is remedial synthesis Pathway, some raw materials of the de novo synthesis pathway are mainly some phosphoric acid, ribose, amino acids, and one-carbon units in the body, which are generated under some enzymatic reactions, and the main place of metabolism is in the liver.
Another pathway is the rescue synthesis pathway. The place of the rescue synthesis pathway is mainly in the bone marrow and brain. Some myeloproliferative diseases, If this remedial synthesis pathway is affected, it will cause abnormal metabolism of purine, which will lead to excessive production of its metabolites and uric acid. Certain drugs will also inhibit purine metabolism, so excessive uric acid will be produced, because the final product of purine They are all uric acid, so you must pay more attention and drink plenty of water.
1. Endogenous: Cells in the human body will go through the process of aging, death and decomposition, and the nucleic acid in the cells will form purines during the decomposition process. This part of purines occupies most of the body and is still uncontrollable.
2. Exogenous: mainly purines in food, the food we take in every day, no matter Whether it is plant-based or animal-based, it contains more or less purines. Purines are metabolized in the body and eventually form uric acid, which is then excreted through the kidneys in the form of urine. Once excessive uric acid is produced or kidney function is impaired , will lead to elevated levels of uric acid, causing damage to the body.
02
How do purines decompose and metabolize after entering the body?
Purine refers to a substance that exists in our body, mainly in the form of purine and nucleotide Existence, purine plays a very important role in the energy supply of the human body, metabolic regulation and the composition of coenzymes, etc. The metabolism of the family is mainly divided into two categories, one is anabolism and the other is catabolism.
When purine metabolism is abnormal, it will cause hyperuricemia, also known as gout, which is characterized by recurrent acute Gouty arthritis, showing uric acid nephropathy, and urinary tract stones and severe gout, patients will show joint deformities, and dysfunction and renal insufficiency.
In the human body 80% of uric acid comes from endogenous purine metabolism, and 20% comes from food rich in purine or nucleic acid protein. The concentration of serum uric acid in normal people fluctuates within a relatively narrow range. Generally speaking, uric acid increases with age.
Especially in menopausal women, blood uric acid levels are affected by multiple factors such as ethnic eating habits, region, age, body surface area, etc. Normal people generally have a blood and urine concentration of no more than 420 μmol/L, so when checking whether a patient has hyperuricemia or purine metabolism disorders, only the blood uric acid level should be checked.
03
Expose the “king of purines” in vegetables! Doctor: try to avoid these 4 kinds of vegetables
1. Laver: Laver is a common aquatic plant, and its purine content is also very high. Every 100 grams of laver contains 150 1 mg to 500 mg of purine, these purine substances will increase the uric acid content in the body after entering the body, if not excreted in time, it may induce hyperuricemia and gout.
Patients with gout and hyperuricemia should eat less or not eat seaweed in normal times to prevent excessive uric acid levels in the body from causing joints, The formation of local gout stones affects normal work and life.
2. Asparagus: Asparagus contains a variety of amino acids, proteins and vitamins, which can lose weight, reduce blood fat, The effect of clearing heat and diuresis, although asparagus is delicious, crisp and delicious, but it is also very high in purines. Every 100 grams of asparagus contains 100-500 mg of purines. It is a veritable high-purine food. People with high uric acid levels are recommended to stay away as soon as possible.
3、 Bean sprouts: The dietary fiber content in bean sprouts is very high, and regular consumption is good for laxatives, but the purine content in bean sprouts is also very high, with 500 mg of purine per 100 grams of bean sprouts. Eating it is not conducive to the stability of uric acid, causing the level of uric acid to soar after meals. It is not recommended for patients with high uric acid and gout patients to eat more.
4. Kidney beans: Kidney beans are a common bean food, and the purine content is also very high. Every 100 One gram of green beans contains about 29 mg of purine. Eating too many green beans at one time will increase the level of uric acid in the body, and even cause acute gout, which will seriously damage the health of the elderly. It is recommended that you suffer from gout And people with high uric acid levels, it is best not to eat.
04
Extension–What drugs can be taken as adjuvant treatment for high uric acid?
Currently commonly used drugs for the treatment of high uric acid clinically, according to their different action substrates, It can be divided into drugs that inhibit uric acid synthesis, such as allopurinol tablets, febuxostat, and drugs that increase uric acid excretion, such as benzbromarone, sulfinpyrazone, probenecid, etc. High uric acid is mainly due to eating a large amount of high Purine foods, and metabolic diseases such as hyperlipidemia and diabetes.
Drugs that inhibit uric acid synthesis
1. Allopurinol tablets : By preventing the metabolism of hypoxanthine and xanthine into uric acid, thereby reducing the production of uric acid, it is mainly suitable for primary and secondary hyperuricemia, and hyperuricemia with renal insufficiency.< /span>
Allergy to allopurinol tablets, severe liver and kidney insufficiency, patients with obvious low blood cells, as well as pregnant women and lactating women are contraindicated. It should also be noted that allopurinol tablets cannot control the acute inflammatory symptoms of gouty arthritis, and cannot be used as an anti-inflammatory drug. You should drink plenty of water during the medication, which is conducive to the excretion of uric acid.
If you are It is forbidden to use azathioprine, mercaptopurine or cholophylline. Pregnant women and lactating women need to be evaluated by a doctor before using it. In order to prevent gout attacks when febuxostat is used, it is recommended to use it at the same time When taking non-steroidal anti-inflammatory drugs or colchicine, pay attention to detecting blood uric acid levels.
Drugs that increase uric acid excretion
1. Benzbromarone: usually effective Inhibits uric acid production and has dual effects on reducing uric acid concentration. It is mainly suitable for primary hyperuricemia and gouty arthritis in the intermittent period. Patients allergic to benzbromarone, patients with kidney stones, and pregnant and lactating women are contraindicated .
If persistent diarrhea occurs during the medication, the drug should be discontinued, and it should not be taken during the gout attack period. Apply colchicine or anti-inflammatory drugs.
2. Sulfinpyrazone: It can competitively inhibit the active reabsorption of urate in the proximal convoluted tubule , increase uric acid excretion, reduce blood uric acid concentration, mainly used in patients with chronic gout, and those with severe liver and kidney insufficiency are contraindicated. Patients with blood diseases, ulcer diseases, and kidney stones need to use it with caution. Pregnant women and lactating women also need regular Use after doctor’s examination.
3. Propanesulfone Shu: It can inhibit the active reabsorption of urate in the proximal convoluted renal tubule, increase the excretion of urate, thereby reducing the concentration of urate in the blood, and is mainly suitable for hyperuricemia accompanied by chronic gouty joints Patients with inflammation and tophi.
It is contraindicated for those who are allergic to sulfa drugs, and those with renal insufficiency, have kidney stones or have a history of kidney stones The patients need to be used with caution. The adverse reactions of this drug are relatively large, and there are few clinical applications at present.