Uric acid is a product of purine metabolism in the body. There are two sources of purine in the body: endogenous relying on its own synthesis or nucleic acid degradation (about 600 mg/d), which accounts for about 80% of the total uric acid in the body; exogenous being the ingested purine diet (about 100 mg/d), which accounts for about 20% of the total uric acid in the body. In the physiological state, the body pool of uric acid is 1200 mg, producing about 750 mg per day and excreting about 800-1000 mg, 30% of which is excreted from the intestine and biliary tract and 70% via the kidneys. Under normal conditions, the daily production and excretion of uric acid in the human body is basically in dynamic balance, and any factors that affect the production and/or excretion of serum uric acid can lead to an increase in serum uric acid levels. When the blood uric acid concentration is too high, uric acid is deposited in the form of sodium salts in joints, cartilage and kidneys, causing a foreign body inflammatory reaction in the tissue, i.e. gout. Yang Lihui, cadre ward, People’s Hospital of Tibet Autonomous Region
Diagnosis of asymptomatic hyperuricemia
The international diagnostic criteria for HUA are defined as a serum uric acid level >420 μmol/L (7 mg/dl) in men and >357 μmol/L (6 mg/dl) in premenopausal women.
Risk factors for the development of hyperuricemia
People with advanced age, men, history of hyperuricemia in first-degree relatives, sedentary lifestyle, cardiovascular risk factors and renal insufficiency are prone to develop hyperuricemia. Epidemiological studies have shown that obesity, hypertension, hypertriglyceridemia, and excessive alcohol intake are risk factors for the development of hyperuricemia, and their prevalence varies somewhat by race and region. There may be an association with hematocrit in highland areas.
Treatment of asymptomatic hyperuricemia and gout
Lifestyle improvement and aggressive treatment of metabolic risk factors associated with elevated uric acid.
Lifestyle improvement is central to the treatment of hyperuricemia and includes a healthy diet, smoking cessation, consistent exercise and weight control. For individuals with existing gout, hyperuricemia, metabolic cardiovascular risk factors and the middle-aged and elderly, diet should be based on low purine foods (e.g. various cereal products, fruits, vegetables, milk, dairy products, eggs) and strict control of foods with high purine content (including animal offal, sardines, anchovies, thick broths and beer, followed by seafood, meat and legumes). At the same time, active control of cardiovascular risk factors associated with hyperuricemia should be an important part of treatment. Since the development of gout is closely related to diet, patients with gout should not eat or eat less purine-rich foods. Drinking 2000 ml to 3000 ml of water daily should be ensured to promote uric acid elimination. Advocate eating more fresh vegetables and fruits, and moderate consumption of protein-containing foods, such as chicken and milk. Avoid foods with high purine content, such as beef and animal offal; eat less peas, lentils, mushrooms, etc., as well as cocoa, coffee, wine, spices and condiments. Special emphasis should be placed on not drinking alcohol, including beer and wine. Long-term heavy alcohol consumption is detrimental to gout patients in three ways.
1) It can lead to an increase in blood uric acid and an increase in blood lactic acid.
2) It can stimulate purines to increase.
3) Drinking alcohol often eat high purine food, wine can accelerate the metabolism of purine, resulting in an increase in blood uric acid levels in the body and trigger an acute attack of gouty arthritis.
Treatment and prevention of hyperuricemia
1. Restrict high-fat and high-protein diet and control calorie intake.
2. Abstain from alcohol.
3. Salt and spicy condiments should be appropriately limited.
4. Eat more fruits and vegetables.
5. Drink plenty of water (2000ml to 3000ml per day).
6. Aerobic exercise.
Dietary treatment for patients
Diet is the main source of exogenous purines and uric acid in patients with hyperuricemia, i.e. gout, and uric acid is mainly derived from the breakdown of nucleotides in the diet. For hyperuricemia, endogenous metabolic disorders are more important than exogenous factors. Therefore what you can’t eat and what you can eat when you have hyperuricemia, i.e. gout, is quite important. Patients must pay attention to hyperuricemia, i.e. gout, diet at the same time as hyperuricemia, i.e. gout treatment.
The value of purine content per 100g of food in daily diet (per 100g/mg )
Food name
Purine (mg)
Name of food
Purine (mg)
Food name
Purine (mg)
Flour
2.3
Millet
6.1
Rice
18.1
Soybeans
27.0
Walnuts
8.4
Chestnuts
16.4
Peanuts
33.4
Onion
1.4
Pumpkin
2.8
Cucumber
3.3
Tomato
4.2
Green Onion
4.7
Bok Choy
5.0
Spinach
23.0
Potatoes
5.6
Carrot
8.0
Celery
10.3
Bok choy leaves
14.5
Cauliflower
20.0
Apricot seeds
0.1
Grapes
0.5
Pears
0.9
Apples
0.9
Orange
1.9
Jam
1.9
Milk
1.4
Egg
0.4
Beef
40.0
Mutton
27.0
Hen
25~31
Goose
33.0
Pork
48.0
Veal
48
lung
70.0
Kidney
80.0
Liver
95.0
Cinnamon Meat
24.0
Gunfish
45.0
Sardine
295
Honey
3.2
pancreas
825.0
Anchovy
363
1. Foods with little or no purine content: refined white rice, corn, refined white bread, steamed bread, noodles, macaroni, soda crackers, cabbage, carrot, cucumber, eggplant, kale, lettuce, pumpkin, tomato, radish, yam, potato, kimchi, pickles, longan, cabbage, various eggs, milk, condensed milk, yogurt, cream of wheat, various fruits and dried fruits, candy, various beverages including soft drinks The following are some of the most popular beverages: soft drinks, tea, chocolate, coffee, cocoa, etc., various fats, peanut butter, peanuts, almonds, walnuts, jams, etc.
2.Foods with purine content <75mg per 100g: asparagus, cauliflower, string beans, green beans, peas, beans, spinach, mushrooms, muesli, herring, anchovy, salmon, tuna, white fish, lobster, crab, oyster, chicken, ham, lamb, beef soup, wheat bran, bread, etc.
3.Foods with purine content of 75mg~150mg per 100g: lentils, carp, sea bass, pike, mackerel, shellfish, prosciutto, pork, beef, beef tongue, veal, chicken soup, duck, goose, pigeon, quail, pheasant, rabbit, lamb, venison, broth, liver, turkey, eel and eel.
4. Foods with purine content of 150mg~1000mg per 100g: pancreas 825mg, anchovies 363mg, sardines 295mg, beef liver 233mg, beef kidney 200mg, brain 195mg, gravy 160~400mg .
Note the food to be eaten less
1.Animal offal
2, seafood, shellfish, etc.
3.Adequate amount of salt Avoid spicy
4.Control the amount of fat
5.Control the amount of salt
6.Control sugar diet
7, control drinks, recommended daily water intake of about 2000-3000ml
8, control the amount of alcohol and soy products