When it comes to diabetes, everyone is familiar with it. It has long occupied the first place among Chinese people with metabolic diseases, and it is a well-deserved “star disease”.
However, in recent years, a new upstart has emerged, quietly pulling diabetes down from the altar, becoming the first brother of chronic diseases (metabolic diseases) in my country, and renaming the “three highs” to “four highs”. high”, it is — hyperuricemia.
In 2017, a study published in Scientific Report, a sub-journal of the internationally renowned journal Nature, showed that the prevalence of hyperuricemia in China has increased from the 1980s 1.4%[2] rose to 13% (male 18.5%, female 8.0%)[1], equivalent to over 170 million people suffering from it.
Source: Tencent Medical Illustrator
Prevalence of hyperuricemia in China in 2016 (by gender/age)
At this point, the controversy over “who is the first brother of metabolic disease” has come to an end.
Yes, hyperuricemia has become the number one metabolic disease in my country!
When it comes to hyperuricemia, the first thing that comes to mind is gout.
It doesn’t sound like much, but doctors love to mix them up.
So, is there any difference between them? OK, let’s have a look.
Gout, figuratively speaking, is because the level of uric acid is too high to dissolve in the blood, and countless “needles” (crystals) are precipitated in the blood, and These needles pile up, causing painful inflammatory attacks in and around the joint.
You can imagine how painful it is to have “needles” all over the joints.
Source: Uric Acid Crystals in Zhanku Hailuo Sediment
Conceptually, gout must be hyperuricemia patients, but not all hyperuricemias become gout, gout is only a very severe form of hyperuricemia. A small part of the population accounts for about 5-12% [2].
But it is not that people who have gout will have higher uric acid than those who do not have gout. Clinically, they will also encounter gout with more than 300 uric acid, while uric acid has remained at 500 for more than ten years. Many patients with hyperuricemia may not develop gout.
So, remember the two indicator limits: 420μmol/L for males; 360μmol/L for females, if you exceed them, pay attention!
Answer: No.
This is about the origin of uric acid.
Speaking of which, for a long time, people believed that uric acid had no benefit other than gout.
Here, we’re going to talk about a long history and give uric acid its name.
The latest research shows[3] that in the long history of human evolution, in the presence of fructose in mammals, uric acid can promote the accumulation of body fat and help ancient primates (old ancestors of humans) survive the earth Cold period of food scarcity[4][5].
InIn the early Eocene, the earth’s climate became warmer, and ancient primates could obtain more fruity foods (fruits), which are rich in ascorbic acid (Vc), which is an effective antioxidant and maintains the body of primates. Antioxidant levels.
But later, the earth’s climate gradually became colder, and the fruits of the old ancestors became less and less. In order to maintain sufficient antioxidant levels in the body, the uric acid in the body bravely stood up and took on the role of Compensating for the loss of Vc synthesis in vivo also drives human evolution.
Source: Zhanku Hailuo
Overall, the effects of uric acid include:
Inhibit the oxidation of unsaturated fatty acids and vitamin C to prevent thrombosis;
When the body is deficient in vitamins, uric acid can replace it for antioxidant effect;
Inhibits the occurrence of cancer cells in the body, resists oxidation and prevents cell mutation.
Therefore, uric acid has made outstanding contributions to the human body, so don’t kill it with one shot.
However, now that people are eating better and better, high uric acid is becoming more and more common. It hurts people “invisibly” and brings a lot of harm to the human body.
Gout, once a royal disease and a disease of wealth, is a disease that increases in prevalence with age. In ancient Western medicine, gout was also thought to be related to sexual immorality.
However, with the change of modern diet structure, more and more people sigh: “I have no emperor’s life, but I have the emperor’s disease.”
And, gout is getting younger and worse!
Recently, a variety show revealed that 23-year-old Guo Qilin also joined the TF-Boys (Gout Boys) boy group.
Source: Internet
Even in the hyperuricemic stage, the population is getting younger and younger.
For example, in Ningbo, the age of the affected population in 2006 was 15 years younger than that in 1998: men were 15 years younger and women were 10 years younger[2]…
A 2011-2013 entrance examination for two universities in Kunming showed that the prevalence of hyperuricemia was 14.79% for boys and 1.04% for girls [6]. The name of TF-Boys is really worthy of the name (boys are more common).
In order to remind more people to pay attention to Rejuvenation of hyperuricemia, our country designated April 20 as “National Awareness of Gout Day” .
The theme for 2018 is: Gout prevention starts with teenagers.
Some diseases are “patriarchal”, hyperuricemia is a typical example.
As mentioned above, the prevalence of hyperuricemia in Chinese men is 18.5%, which is significantly higher than that in women, which is 8% [1]. Even in a school in Kunming, the prevalence rate of adolescent boys reached 14.79%, and only 1.04% of women [6].
Why is uric acid higher in men?
The reason may be related to male uric acid “more production and less discharge”, such as:
Men were significantly higher than women in alcohol consumption, frequency and high-purine diet.
Androgens inhibit the excretion of uric acid by the kidneys, resulting in elevated levels of uric acid in the body.
Androgens accelerate the formation and deposition of uric acid crystals; estrogens promote uric acid excretion.
Once a man finds that uric acid is higher than 420μmol/L, he should pay attention to it. On the one hand, he should follow the doctor’s recommended drugs to reduce uric acid, and on the other hand, adjust his lifestyle. The following things are especially careful. :
1.Limit alcohol, especially beer;
2. No smoking;
3. Keep warm and avoid catching a cold;
4. Increase intake of fresh vegetables;
5. Maintain regular diet and rest;
6. Reduce the intake of high-purine foods, such as animal offal, seafood, meat, etc.;
7. Reduce the intake of fructose-rich beverages and check the ingredients of the beverages before drinking;
8. Maintain regular exercise, but try to choose gentle exercise such as jogging and walking;
9. Control your weight and keep your body mass index (BMI) within 25.
Some people say, “I have high uric acid, as long as I don’t have a gout attack, I’m fine; even if I have gout, it’s just a little pain, and it’s not a big problem.” — remember, this notion is very common Danger!
Source: Zhanku Hailuo
This is because: Hyperuricemia not only damages the joints, but also quietly damages the heart, brain, kidneys and other important organs!
The most common, but also the most likely to attract patients’ attention, is gouty arthritis. Once it occurs, it is an early warning signal. Don’t “get the scar and forget the pain”.
A gout attack is just the first step. The most common damaged organ after the joints is the kidneys. The serum uric acid content continues to be too high, and urate crystals are deposited in the kidneys to form stones.
Although uric acid contributed to the evolution of human upright walking. However, the survival advantage provided by elevated uric acid has long been lost after the improvement of human living standards and changes in dietary structure.
Instead, numerous prospective epidemiological studies have found that hyperuricemia is an independent risk factor for multiple cardiovascular diseases!
The higher the uric acid exceeds the warning range, the greater the risk of stroke, diabetes, coronary heart disease, hypertension, heart failure, myocardial infarction, kidney disease and other diseases, and the worse the treatment effect.
Recipes are often found on the Internet and are widely circulated.
For example, patients with hyperuricemia cannot eat mushrooms and spinach because of the high purine content.
This makes mushrooms really uncomfortable.
Is it really impossible to eat? This question is answered in two ways:
Mushrooms and spinach are not high purine foods, fresh mushrooms are moderate purine foods[7], and spinach is low purine foods. The conclusion circulating on the Internet that shiitake mushrooms are high purine foods refers to the purine content of dried shiitake mushrooms; while the fear of spinach stems from the rich oxalic acid content in spinach, which “collided” with uric acid.
A study published in the International Journal of Nutrition in 2010 also showed that alkaline foods such as mushrooms and vegetables can help dissolve and excrete uric acid in the blood [8].
Therefore—Mushrooms and vegetables can be eaten, and may even be good for lowering uric acid!
Of course, it is recommended to blanch it when eating.
Similarly, skimmed milk, with its high protein and low fat properties, is also an excellent drink for patients with hyperuricemia.
On the contrary, some foods that are considered good things, such as honey, contain a lot of sugar, and like sugar-sweetened beverages, the more you drink, the higher the uric acid!
Okay, we’ve talked about this, and by the way, I’ll give you a high uric acid diet tip:
These foods can increase uric acid when you eat them
Source: Tencent Medical Illustrator
“Limiting” of high-purine foods is key
The nutrition of the body must keep up, and high-purine foods must be eaten, but must be limited, including:
Source: Tencent Medical Illustrator
These foods are unlimited and nutritious daily
Source: Tencent Medical Illustrator
In addition, the most important thing for patients with high uric acid is to pay attention to drinking more water. Drink at least 2000 ml of water a day, and drink some light tea and coffee appropriately, which can help to eliminate uric acid, but pay attention to , too strong coffee will increase the burden on the kidneys, don’t be greedy, one cup after another cup of wine is not good.
References
[1] Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2017 Edition), Diabetes Branch of Chinese Medical Association, 2018, 10(1): 4-67.
[2] Endocrinology Branch of Chinese Medical Association. Chinese expert consensus on the treatment of hyperuricemia and gout[J]. Zhonghua Endocrinology and Metabolism Za, 2013, 29(11): 913-920 .
[3] Cicerchi C, Li N, Kratzer J, et al. Uric acid-dependent inhibition of AMP kinase induces hepatic glucose production in diabetes and
starvation: evolutionary implications of the uricase loss in hominids. FASEB J. [Epub ahead of print]
[4] Johnson RJ, Andrews P. Fructose, uricase, and the back-to-Africa hypothesis. Evol Anthropol, 2010, 19(6):250-257.
[5] Lanaspa MA, Sanchez-Lozada LG, Choi YJ, et al. Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress:
potential role in fructose-dependent and -independent fatty liver.
[6] Wu J , Qiu L , Cheng X Q , et al. Hyperuricemia and clustering of cardiovascular risk factors in the Chinese adult population[J]. Scientific Reports, 2017, 7(1) :5456.
[7] Li Jing, LiJing. Epidemiological study of hyperuricemia[J]. China Cardiovascular Journal, 2016, 21(2):83-86.
[8] Xiong Xiangling, Zhao Jiang, Chen Hongwei, et al. 2011-2013 analysis of health examination results of freshmen in college [J]. Modern Preventive Medicine, 2015, 42(20):3733- 3735.
[9] Sun Peilong, Wu Xueqian, Ji Peijun, et al. Detection of purine content in Lentinus edodes and other edible fungi[J]. Food Industry Science and Technology, 2000, 21(5):70- 72.
[10] Kanbara A , Hakoda M , Seyama I . Urine alkalization facilitates uric acid excretion[J]. Nutrition Journal, 2010, 9(1):45.
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