Let you know about the hidden "fourth high" - hyperuricemia

As we all know, there are the famous "three highs" in the disease world: high blood pressure, high blood sugar, and hyperlipidemia. However, in recent years, many people have quietly "gotten" the "fourth high" - hyperuricemia. At present, the prevalence of hyperuricemia has exceeded that of diabetes, about 13.3%, that is, more than 1 in 10 people in mainland China suffer from hyperuricemia. At the same time, it is not difficult to find that many male friends around us are "early acid", because hyperuricemia prefers the male group, with the prevalence of men and women being 19.4% and 7.9% respectively. Let us understand this hidden "fourth high" - hyperuricemia through ten questions.

Question 1: How high does uric acid level need to be to be considered hyperuricemia?

Although men generally have higher blood uric acid levels than women, the latest guidelines point out that the biochemical definition of hyperuricemia is a blood uric acid level of more than 420 micromoles per liter on two different days, regardless of gender and age. It is a metabolic syndrome caused by purine metabolism disorder.

Question 2: How does uric acid become high?

The occurrence of any disease is related to genetic factors, and hyperuricemia is no exception. However, apart from genetic factors, the incidence of hyperuricemia is increasing year by year due to the improvement of living standards. The main reasons are: excessive uric acid production (eating too much purine-rich food, strenuous exercise, drinking, obesity, idiopathic rhabdomyolysis, etc.) or reduced uric acid excretion (renal insufficiency, polycystic kidney disease, diabetes, hypertension, acidosis, etc.). In addition, there is a mixed hyperuricemia in which both conditions exist at the same time.

Question 3: How much do you know about the dangers of high uric acid?

Continuous increase in blood uric acid can cause the following hazards: uric acid deposits in the joints, causing gouty arthritis, and can lead to joint destruction and deformation; when deposited in the kidneys, it can cause kidney damage, gouty nephropathy, and urinary stones; high uric acid can also stimulate blood vessel walls and promote atherosclerosis; it can cause inflammatory oxidative stress reactions, damage pancreatic beta cells, and subsequently cause insulin resistance and aggravate diabetic metabolic syndrome.

Question 4: Can hyperuricemia be controlled by controlling one’s diet?

The answer is not completely correct, because 20% of uric acid in the body comes from diet and 80% comes from cell metabolism, so strict dietary control can only reduce blood uric acid by 60 to 120 micromoles per liter. At the same time, long-term strict dietary control is difficult to achieve and may lead to malnutrition. Therefore, severe hyperuricemia requires timely medical treatment and drug treatment to reduce uric acid levels.

Question 5: What tests do patients with hyperuricemia need to undergo?

When people discover hyperuricemia, they should seek medical attention promptly and undergo appropriate examinations under the guidance of a doctor. Relevant examinations may include:

1. Blood test: uric acid, blood creatinine, blood lipids, blood sugar;

2. Urine examination: uric acid, urine pH value;

3. Dual-source CT examination: Check whether there is urate crystal deposition in the joints;

4.B-ultrasound: Check whether there are stones in the urinary system;

5. X-ray examination: check for bone destruction;

6. Joint fluid examination: identification of crystals and inflammation;

7. Histological examination: urate crystals.

Question 6: Can I still drink alcohol if my uric acid level is high?

For patients with hyperuricemia, drinking is not recommended, especially during the acute attack of gout and chronic gouty arthritis. Drinking is strictly prohibited. During the intermittent period of gout and when the blood uric acid level reaches the standard, drinking can be controlled. Men should not exceed 2 units of alcohol per day, and women should not exceed 1 unit of alcohol per day (1 unit of alcohol ≈ 14 grams of pure alcohol). The density of alcohol is 0.8 grams per milliliter, and the volume of 14 grams of pure alcohol is 17.5 milliliters. Women should not drink more than about one tael of 42-degree liquor at a time, and men should not drink more than about two taels.

Question 7: What are the dietary precautions for hyperuricemia?

Limit purine intake to less than 200 mg per day. Avoid foods such as organ meats, seafood, crustaceans, soups and gravy. Limit foods such as red meat and phosphorus-free fish (catfish, eel, eel, loach, hairtail, pomfret, etc.). Also limit high-fructose corn syrup, such as pizza sauce, ketchup and barbecue sauce, most breakfast cereals (especially those with added sugar), and fructose-containing beverages or sugary soft drinks, juices, etc.

Foods that are encouraged to be consumed include skim or low-fat milk (300 ml per day), 1 egg per day, 500 grams of fresh vegetables per day, and low-glycemic index cereals (whole grains). It is also recommended that patients with hyperuricemia drink 2 to 3 liters of water per day (patients without heart or kidney disease), and weakly alkaline, small molecule water should be used as drinking water. Studies have found that lemon water (such as 1 to 2 fresh lemon slices added to 2 to 3 liters of water) helps lower uric acid, but it is not recommended to add vitamin C supplements to gout patients. Dietary points run through the entire disease, not limited to the active period.

Question 8: Is hyperuricemia gout?

Hyperuricemia is not equal to gout. About 5% to 12% of hyperuricemia will develop into gout, and the rest will have no symptoms. However, the higher the blood uric acid level and the longer the duration, the greater the chance of gout and urinary stones. Therefore, hyperuricemia is the biochemical basis and direct cause of gout, and gout is just the tip of the iceberg of hyperuricemia.

Question 9: What is gout: "The disciple is better than the master"?

Gout is often jokingly called "crazy pain". It is like a gust of wind, coming and going in a hurry, and every time it blows, it makes people crazy with pain. It is a joint disease caused by the deposition of urate crystals in patients with long-term hyperuricemia. Acute attacks of gouty arthritis often have triggers, and often occur in cases of drinking, eating high-purine foods, etc. The onset is acute, and the affected joints will become red, swollen, hot, painful and dysfunctional within a few hours. It is prone to occur at midnight or early morning. Single joints are common, and unilateral attacks are best in the first metatarsophalangeal joint, followed by ankles, fingers, knees and elbows. It is self-limited and relieves on its own within a few days to 2 weeks, but it is easy to relapse and often has a family history.

Question 10: Can I use hot or cold compresses when I have a gout attack?

No, especially during the acute stage of gout attack, especially within 48 hours, hot compress is prohibited, because hot compress in the acute stage will aggravate the congestion and edema of the affected area, not only can not relieve pain, but sometimes make the pain worse. Cold compress only temporarily relieves local pain, and low temperature stimulation will cause blood vessels to contract and blood flow to decrease, which is not conducive to the absorption and dissipation of inflammation. At the same time, local low temperature may further deposit uric acid under the skin, aggravating local inflammation.

Through the study of the above ten questions, we have unveiled the hidden veil of hyperuricemia. Take care of yourself, live a healthy life, and say no to high uric acid.