High uric acid can cause gout, so the lower the uric acid, the better?
Uric acid is the end product of purine metabolism in the human body. Generally, the normal range of men is 149-416 μmol/L, and the normal range of women is 89-357 μmol/L (the reference value of different hospitals may vary slightly).
When uric acid is produced too much or uric acid excretion decreases, it will lead to elevated uric acid.
Whether male or female, the blood uric acid level exceeds 420μmol/L twice on different days, which is called hyperuricemia.
In recent years, the incidence of hyperuricemia in my country has been increasing year by year.
It is estimated that the number of patients with hyperuricemia in my country has reached 120 million.
If hyperuricemia is not effectively controlled, it may develop into gout.
Many people equate hyperuricemia with gout, which is wrong.
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In fact, only 5% of patients with hyperuricemia ~12% will develop gout.
Gout can only be diagnosed when hyperacidemia causes urate crystal deposition and clinical manifestations such as acute arthritis, tophi or gouty nephropathy.
Elevated uric acid is indeed harmful, but the lower the uric acid is, 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, which can easily induce exercise-related acute kidney injury, which usually occurs in Within 6 to 12 hours after strenuous exercise, patients will experience severe abdominal pain and nausea.
Urinary tract calculus is the most common complication of renal hypouricemia. Because there is less 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 stones can cause renal colic, hematuria, urinary tract infection, and even block renal tubules, leading to acute renal failure.
Studies have found that patients with hypouricemia are more likely to experience worsening cognitive function and a higher risk of dementia, and the impact mechanism is more complex.
If the patient has memory loss, he should be highly vigilant for hypouricemia.
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Some scholars also found that when the blood uric acid level ≤240μmol/L , the risk of acute myocardial infarction, heart failure, coronary heart disease and other cardiovascular diseases increases.
Uric acid can remove harmful reactive oxygen species and is one of the important antioxidants in plasma.
If the uric acid level is too low, it can lead to a decrease in the patient’s antioxidant capacity, vascular endothelial dysfunction, and aggravate atherosclerosis, thereby increasing the risk of cardiovascular events.
So the uric acid should not be too high, nor should it be too low, the key is to control it within a reasonable range.
Source｜”Family Medicine” Issue 19, October 2022
< p data-track="25">Editor｜Zhang Wanbo
Proofreading｜ Zheng Ke
Second trial｜Zhang Yue
Final Judgment｜Liu Huiying Zhang Ruxian