Hyperuricemia (HUA) is defined as fasting serum uric acid levels >420 umol/L (7 mg/L) in men and postmenopausal women, and >357 umol/L (6 mg/L) in premenopausal women, measured on 2 non-same-day occasions on a normal purine diet. When blood uric acid saturation is exceeded, urate crystals precipitate and are deposited in various parts of the body, such as joints, blood vessel walls, and soft tissues. Gout is a painful inflammatory joint disease caused by the deposition of uric acid crystals in joints and surrounding soft tissues. Count the five “unforgivable” sins of HUA The first sin: destruction of joints The prevalence of gout increases with the rise in blood uric acid levels. Studies have reported that the prevalence of gout is 1.3%, 3.2% and 17.6% for serum uric acid <360 umol/L, 360~479 umol/L and >480 umol/L, respectively. A study with 2-10 years of follow-up showed that knee joint fluid urate crystals were seen in 87.5% of patients when blood uric acid was >360 umol/L, while only 43.8% of patients developed them when blood uric acid was ≤360 umol/L. Another study showed that when controlling blood uric acid ≤360 umol/L, there was only 1 attack of gouty arthritis in the recent 1 year, while there were as many as 6 attacks in those with blood uric acid >360 umol/L. This suggests that: controlling blood uric acid below 360 umol/L is beneficial to the control of gout and the dissolution of uric acid crystals. The second sin: injury to blood vessels HUA is an independent risk factor for hypertension. Studies show that for every 60 umol/L increase in blood uric acid level, the relative risk of developing hypertension increases by 13%. In a survey of HUA population in Guangdong Province in 2015, it was found that about 20% of HUA population had combined hypertension. The third sin: kidney injury HUA can lead to acute uric acid nephropathy, chronic uric acid nephropathy and kidney stones, increasing the risk of renal failure, and renal insufficiency is an important risk factor for HUA and gout. Studies have shown that for every 60 umol/L increase in blood uric acid, the risk of chronic kidney disease (CKD) increases by 70% and the risk of deteriorating kidney function increases by 14%. The prevalence of CKD in patients with normal blood uric acid levels is about 11%, while HUA combined with CKD is as high as 32.7%. The fourth sin: chaotic metabolism HUA is an independent risk factor for type 2 diabetes. Studies have shown that for every 60umol/L increase in blood uric acid level, the relative risk of developing diabetes increases by 17%, and the risk of diabetes in patients with HUA increases by 95% compared to those with normal blood uric acid. In addition, studies have also found a positive correlation between HUA and the occurrence of obesity, high triglycerides, hypercholesterolemia and other lipid metabolism disorders. The fifth sin: shortening life expectancy Studies have shown that the average life expectancy of patients with HUA combined with gout is 15 to 20 years shorter than normal. 2010 Global Burden of Disease (GBD) expert group on musculoskeletal diseases and risk factors assessed the global burden of gout and the results suggested that the disability alive years (DALYs) of gout patients were significantly higher in 2010 than in 1990. Gout, which six groups of people are favored? (1) 95% of gout cases occur in men. This is because men tend to drink alcohol and eat purine- and protein-rich foods, while estrogen in women’s bodies has the effect of promoting the excretion of uric acid by the kidneys and inhibiting arthritis attacks; (2) gout is likely to patronize middle-aged people. 40-55 years old is the age of high incidence of gout, but in recent years there has been a trend towards younger people; (3) obese people are prone to it. 60%-70% of gout patients are obese, and 85% of gout patients under 40 years old are overweight. (3) Obese people are prone to gout. 60% to 70% of gout patients are obese, and 85% of gout patients under 40 years old are overweight. If the father suffers from gout, the incidence rate of his offspring can be 50% to 60%; (5) People who often eat excessive amounts of high purine, high protein, high fat food and drink a lot of alcohol for a long time are prone to gout. According to some doctors, the incidence of gout is 30% in those who have a constant feast, and the incidence of gout is also more in those who often eat hot pot; (6) the incidence of gout can also be increased by kidney function damage caused by various reasons, blood diseases, radiotherapy for tumors and long-term use of certain drugs. Pain is crazy! When it comes to the health hazards of hyperuricemia, the first thing that comes to mind is the “pain” of gout. Gout can kill a healthy person overnight, leaving them unable to live a normal life and on crutches or even in a wheelchair. Some patients even suggest that gout should be renamed “gout madness” because the pain can drive people crazy. Gout is only the tip of the iceberg of hyperuricemia, the harm of hyperuricemia is potential, continuous, long-term harm is even greater, must cause sufficient clinical attention. Studies show that HUA is closely related to metabolic syndrome, type 2 diabetes, hypertension, cardiovascular disease and chronic kidney disease, and is an independent risk factor for these diseases. Younger and younger HUA The prevalence of HUA shows an overall trend of increasing year by year, and the characteristics of youthfulness are becoming more and more obvious. In 1998, the prevalence of HUA in Shanghai was 10.1%, in 2003, the prevalence of HUA in Nanjing was 13.3%, in 2004, the prevalence in Guangzhou was as high as 21.8%, and the latest statistics in 2015 found that the average prevalence of HUA in the medical examination population in Tianhe District, Guangzhou was as high as 33.48%. What is more noteworthy is that in 2006, the age of HUA prevalence in Ningbo was 43.6 and 55.7 for men and women respectively, which was 15 and 10 years earlier than the age distribution of men and women in the survey results in Shanghai in 1998. However, in the 2015 Guangdong Foshan physical examination population survey, the average age of disease for male and female HUA was 40.4 and 47.5 years, respectively, which was also earlier than the 2006 survey results. When HUA has silently entered the common people from the imperial family and become the “fourth highest” of human health, people, especially us, the clinical specialists, should be more alert, early detection and early intervention.