Misconception of uric acid

Speaking of the "three high" which poses a great threat to people's health (hyperglycemia, hypertension, hyperlipidemia), we will not feel strange. Nowadays, "the fourth highest" - high uric acid gradually emerges, bringing new hidden dangers to people's health. What if uric acid is high? At present, the trend of hyperuricemia in China is high prevalence, younger, higher in males than in females, and higher in coastal areas than in the mainland.

Uric acid is the product of purine metabolism in human body. There are two sources of purine in human body, self-synthesized purine and intake of purine diet, the latter accounting for about 20% of the total uric acid in the body. Under normal conditions, 30% of uric acid is excreted from the intestine and biliary tract, and 70% is excreted through the kidney. Kidney is an important organ for uric acid excretion. Every day, the production and excretion of uric acid in the human body maintain a balance and maintain the normal level of blood uric acid. Hyperuricemia can occur when the production of uric acid is excessive or the excretion is reduced.

Hyperuricemia refers to a high level of serum uric acid. Hyperuricemia is not the same as gout. About 10% of people with high serum uric acid will get gout. Gout refers to the pathological state of the deposition of uric acid crystals in the body organs, which can be manifested as recurrent arthritis, kidney stones and chronic kidney diseases.

1.Avoid high purine diet and prohibit alcohol consumption one day before blood withdrawal. Require blood withdrawal for examination in the morning on an empty stomach；

2.Within one week before blood withdrawal, discontinue taking medicines that promote uric acid excretion, such as salicylic acid, antihypertensive drugs and diuretics；

3.Avoid strenuous exercises, such as running or high-speed climbing, before drawing blood；

4.Because blood uric acid sometimes fluctuates, repeated examinations should be performed if clinical suspicions are high。

Misunderstanding 1. High uric acid equals gout

Gout originates from hyperuricemia, but not from hyperuricemia. Gout occurs only when uric acid crystals in the blood deposit in the joint synovium and cause synovitis inflammation. In fact, only about 10% of hyperuricemia patients develop gout. Conversely, because the pathogenic factors of gout are complex, many patients may have a normal level of serum uric acid during the onset of gout. At this time, don't be superstitious about the test results and delay the timely treatment of gout.

Misunderstanding 2. High uric acid can only cause gout

Uric acid is the metabolic end product of purine in human body. Hyperuric acid has harmful effects on many tissues and organs of human body. Excessive uric acid deposition in bones and joints can cause gout. Deposition in the kidney can cause kidney disease and renal failure. High uric acid also significantly increases the risk of multiple metabolic-related diseases (such as obesity, diabetes, hyperlipidemia, etc.) and cardiovascular diseases.

Misunderstanding 3. Normal uric acid is everything.

Misunderstanding 3. According to international standards, the normal range of uric acid is < 420 micromol/L for males and < 360 micromol/L for females. However, for gout patients, it is not enough to control uric acid in such a "normal" range. The latest guidelines recommend that the blood uric acid of gout patients should be reduced to less than 360 micromol/L, and those with renal uric acid stones should be reduced to less than 300 micromol/L, thus reducing the recurrence frequency of gout, reducing the number of gout stones formed and further avoiding crystal deposition. Often everything goes well.

Misunderstanding 4. High uric acid, no treatment without gout

No matter how healthy a person is, as long as uric acid exceeds a certain value, it should be treated with hypouric acid. If this person is also associated with diabetes, chronic kidney disease or cardiovascular risk factors, then as long as uric acid is beyond the normal range mentioned above, even if there is no gout attack, treatment needs to be initiated.

Misunderstanding 5. Eating alone can reduce uric acid

Uric acid in human blood, 80% comes from its own purine metabolism, only 20% comes from food intake. Therefore, the effect of dietary control on reducing blood uric acid level is very limited (most of them can only decrease by 10%-20% or 70-90 micromol/L). Therefore, it is necessary to select drugs reasonably according to the condition of the disease. Many patients refuse to take medicine for fear of "side effects of drugs". In fact, the risk of rare complications of drugs will not be very high as long as the drugs are used scientifically and regularly.

Myth 6. Drugs alone are enough to reduce uric acid

After the use of hyaluronic acid drugs, some patients think that they can have a good rest and eat fast in their diet. This idea is not only wrong but also dangerous. For chronic metabolic diseases such as gout, "low purine" diet is the premise and basis of treatment. It is impossible to control the disease without reducing the intake of purine at the source and relying solely on drugs. However, due to excessive diet, uric acid increased significantly, and drug dosage had to be increased, which greatly increased the risk of adverse drug reactions.