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Recently, rumors about the serious illness of Academician Zhong Nanshan have attracted attention on the Internet. According to Nan Fang Daily, Zhong Nanshan said that he is currently suffering from gout and has not recovered for more than 20 days. He has infections in his ankles and other parts, so he cannot walk normally. Gout is a metabolic disease characterized by hyperuricemia and the precipitation and tissue deposition of urate crystals. Do you really know about gout?

Myth 1

Gout favors boys over girls, so women won’t get gout?

Large-scale epidemiological surveys have shown thatGout is more common in menThe male-to-female ratio is about 15:1. Among adults aged 35-79, the standardized prevalence of hyperuricemia is 13.5%. Compared with women, the prevalence in men is higher, reaching 17.3%.

The main cause of gout is hyperuricemia, and uric acid is the end product of purine metabolism in the human body. The kidney is the main pathway for uric acid excretion, and estrogen has the effect of promoting uric acid excretion. Premenopausal women have a large amount of estrogen secretion in their bodies, and the estrogen level in the blood is high, which can promote the excretion of uric acid by the kidneys and help lower the level of uric acid in the blood.

Correspondingly, the sex hormone level in men is mainly androgen. Since androgen reduces the excretion of uric acid from the renal tubules, the uric acid level in male plasma is relatively higher than that in premenopausal women of the same age.

Gout is more common in boys than girls, but that doesn’t mean women can ignore the risk of goutThe risk of gout cannot be neglected, especially for postmenopausal women, whose risk of disease is almost the same as that of men. So when facing gout, women should do the same as men, control their diet, exercise, and drink more water.

Myth 2

Will high uric acid cause gout sooner or later?

First of all, you need to understand one thing.Hyperuricemia and gout are two names for different stages of the same disease.。

Data from the 2021 China Hyperuric Acid and Gout Trend White Paper shows thatThere are about 177 million patients with hyperuricemia in my country, of which nearly 60% are young people aged 18-35. High uric acid has become the "fourth high" after high blood sugar, high blood pressure and high blood lipids.

Hyperuricemia mainly refers to the condition where the uric acid level is greater than 420 micromoles/liter on two different days under normal dietary conditions. In the past, the diagnostic standard for hyperuricemia in women was uric acid level greater than 360 micromoles/liter. Now, the diagnostic standard for hyperuricemia in both men and women is 420 micromoles/liter.

Because uric acid levels are higher than normal for a long time, urate crystals are deposited in the joints of the human body, stimulating the joints to form sterile arthritis, which is gout.

The picture comes from the WeChat official account of the Chinese Society of Rheumatology

Will high uric acid levels definitely cause gout? The answer is not necessarily.Some people have high uric acid levels for a long time but do not have gout attacks, while others have gout attacks while their uric acid levels are still within the normal range.

If you find that your uric acid level is high, you should consult a rheumatologist in time to find out the cause of the high uric acid level and evaluate the condition. Usually, changing your diet and increasing exercise are enough to control most cases of high uric acid levels. Only a small number of people need uric acid-lowering treatment.

Myth 3

Is high uric acid caused by diet?

How much influence does diet have on uric acid? A review published in the British Medical Journal in 2018 showed:The answer is probably less than 5%.。

The study involved 16,760 European adults who did not have kidney disease or gout and ate a moderate-calorie diet. In contrast, genes affected 23.9% of the variation in blood uric acid in men and 40.3% in women.

Although high uric acid and gout are closely related to diet, they are not all caused by diet. Uric acid is metabolized by purine, and purine has two sources: self-synthesis, accounting for 80%; and digestion and absorption from food, accounting for 20%.

Regardless of whether it is ingested through diet or synthesized by the body, purine in the body must be metabolized by the liver into uric acid, and then excreted from the body through the kidneys in the urine and the intestines in the feces.

High uric acid levels cannot be attributed entirely to “eating”, endogenous metabolic disorders are more important reasons, such as insufficient uric acid excretion due to genetics, hypertension or kidney disease.

Which foods are high in purine? Please see the list below↓↓↓

The picture is from the WeChat public account of Healthy Guangdong

Myth 4

Gout favors Cantonese people, so only "grandpas" will get it?

Guangdong Province is well known as a "gout-prone province". The 2017 China Gout Status Report White Paper shows that the number of gout patients in Guangdong Province ranks first in the country. Epidemiological surveys in Guangdong found that the incidence of gout is 3%, and the number of people with excessive uric acid is more than 10%, with an average of 1 gout patient in every 100 people.

Gout "prefers" Cantonese people, which is closely related to their eating habits of drinking old-fashioned soup, eating animal offal and seafood. These eating habits will bring high purine, and frequent consumption will lead to increased uric acid concentration.

In addition, gout is not exclusive to middle-aged people. The post-2000s have already started to suffer from gout. The "2024 Guangdong Province Physical Examination Population Sampling Health Report" shows that the detection rate of male physical examination populations in Guangdong Province is higher than that of females in all age groups. It is worth noting that the detection rate of increased uric acid is inversely proportional to age. More than 4 out of every 10 Guangdong men aged 20-39 have increased uric acid. This generation of Guangdong post-2000 men has already suffered from the disease that only "grandpas" in traditional concepts would get.

Myth 5

Can drinking soda water for a long time prevent and treat high uric acid and gout?

Sodium bicarbonate can alkalinize urine and promote uric acid excretion to a certain extent, but the sodium bicarbonate content of commercially available soda water is very low, and it is difficult to achieve the effect of "lowering uric acid". In addition, long-term use of sodium bicarbonate tablets is also difficult to achieve the effect of uric acid lowering drugs, and it will also lead to excessive sodium intake and increase the risk of hypertension. Therefore,Long-term use of sodium bicarbonate to prevent gout is not recommended。

In addition, sugary drinks can trigger gout attacks, and the culprit is fructose. Fructose metabolism in the body produces a large amount of purine, which leads to increased uric acid.

The "Dietary Guidelines for Adults with Hyperuricemia and Gout (2024 Edition)" issued by the National Health Commission points out that people with hyperuricemia and gout, under normal heart and kidney function, shouldDrink plenty of water, 2000-3000m per day is recommendedL. Try to maintain a daily urine volume of more than 2000mL. White water is preferred, and lemonade, light tea, unsweetened coffee and soda water are also acceptable, but excessive drinking of strong tea, strong coffee, etc., and cold drinks should be avoided.

Sources: National Health Commission, Chinese Society of Rheumatology, Healthy Guangdong WeChat Official Account, Science Popularization China, Health Times, etc.

Editor: Ma Haoge

Proofread by Li Lijun