以下文章来源于果壳 ，作者黎小球 果壳 . 科学和技术，是我们和这个世界对话所用的语言。 本文来自微信公众号： 果壳 ，作者：黎小球，编辑：Odette 中国人的尿酸水平在快速升高。 一项纳入了200多万人的研究显示，从2001年到2017年，中国大陆15岁以上人群高尿酸血症 （HUA）的患病率从8.5%攀升到了18.4%，翻了一倍多，华南更是"重灾区"。 很长一段时间内，人们只知道长期尿酸高，痛风和肾结石的风险会增加。但随着医学研究的不断深 入，尿酸升高与其他慢性病的关联开始浮现。 这是一个重要的公共卫生问题。中国人的尿酸为什么越来越高了？又是什么造成了地区差异？我们试 图揭开这个问题的一角。 中国高尿酸地图 大多数高尿酸血症患者没有症状，得知自己尿酸升高，常源于一张体检单。在人们模糊的印象中，近 些年来查出尿酸升高的人越来越多。 这并不是错觉。2021年发布的一项研究中，研究者分析了177项研究、200多万人的数据，发现2001 年时，中国大陆15岁以上人群高尿酸血症的患病率还在8.5%，到了2017年，数值攀升到了18.4%， 不到二十年翻了一倍多。 2022年发布的另一项全国性调查也得出了惊人的结果。 ...

来源：温州晚报 几颗贡丸、两勺汤，再加上点芹菜末……冬日街头，来上一碗热乎乎的贡丸汤，是一代浙江人儿时的记 忆。40岁的林先生（化名）就是其中之一，近期他突然想回味童年时的味道，没想到连喝了一周，竟然 进了医院。 到医院看痛风 却被确诊尿毒症 "黄医生，我左膝盖疼痛又发作了，走不了路，没扭着，也没伤着，就这周喝了点贡丸汤，又疼了，上 次是2年前疼痛来就诊过……"浙江医院风湿免疫科黄艳医师介绍，林先生是坐着轮椅被推进诊室的。 作为一位痛风"老"患者，林先生两年前开始接受降尿酸治疗，但复查并不规律。黄艳发现他同时患有高 血压、糖尿病、肥胖等合并症。此次进食一周贡丸汤后就医，左膝盖肿胀明显，尿酸超过421umol/L （痛风患者的尿酸应控制在300~360umol/L）。但更让人揪心的是，他的肌酐高达717μmol/L（正常成人 全血中的肌酐参考值为88.4~176.8μmoI/L），肾小球滤过率只有7.5mL/min/1.73m²（正常成年男性在 110~140mL/min/1.73m²）…… 这意味着患者确诊终末期肾病（尿毒症期），此阶段的大部分老年患者都要靠血液透析、腹膜透析或肾 移植维持生命。这让黄艳非常感 ...

尿酸超标，就像多米诺骨牌：不仅容易引起痛风，还会损伤肾脏和全身血管…… 如今，我国高尿酸血症患者已超过1.5亿人，痛风患者已达1500余万。 不少人体检发现尿酸超标后，就想把尿酸水平快速降下去。但在医生看来，降尿酸千万不能太快了。 尿酸降得太快有什么后果？《生命时报》邀请专家告诉你答案，并教你如何科学应对。 尿酸降太快，反而加重关节肿痛 首都医科大学附属北京友谊医院风湿内科副主任医师周航表示，临床上经常遇到这样的患者，为了缓解 关节疼痛，或者希望尽快将尿酸水平降下去，自行用药或自行加大用药剂量，反而出现疼痛不缓解、关 节肿胀加重的情况。 这是因为服用药物后，血液中的尿酸经过代谢很快排出体外，导致血尿酸水平迅速下降。 然而，关节液中的大量高浓度尿酸来不及向血液中转移，从而使关节和血液中尿酸浓度相差悬殊，致使 已经沉积在关节表面的尿酸盐结晶不稳定，骤然脱落释放。 脱落的结晶被免疫系统（如中性粒细胞）识别为"外来异物"，触发剧烈的炎症反应，引起关节红、肿、 热、痛急性发作。 降尿酸不在快，而在"稳" 尿酸降得太快，就好比冬天快速融化冰雪，很有可能导致冰凌坠落或洪水，是一个"欲速则不达"的过 程。 除了可能诱发急性痛 ...

Core Viewpoint - The article highlights the health risks associated with the consumption of popular beverages, particularly those high in fructose, which can lead to increased uric acid levels in the body [1] Group 1: Health Implications - Common beverages such as carbonated drinks, milk tea, and functional drinks contain high levels of fructose [1] - Fructose is the only carbohydrate that can produce uric acid, and excessive intake can lead to hyperuricemia [1] - The metabolism of fructose in cells results in the synthesis of uric acid, while fructose also reduces the excretion of uric acid [1]

Core Viewpoint - Long-term consumption of milk tea and similar beverages may lead to an increased risk of elevated blood uric acid levels due to high fructose content in these drinks [1] Group 1: Health Risks - Common beverages like carbonated drinks, milk tea, and functional drinks contain high amounts of fructose [1] - Fructose is a structural isomer of glucose and is the only carbohydrate that can produce uric acid [1] - Excessive intake of fructose leads to its metabolism in the body, resulting in increased endogenous uric acid synthesis and reduced uric acid excretion, causing hyperuricemia [1]

Core Viewpoint - The rising incidence of gout among younger populations is linked to various factors, and the claim that disodium inosinate is a primary cause lacks sufficient evidence [1][2]. Group 1: Disodium Inosinate and Gout - Disodium inosinate is a food additive found in many condiments, but there is no substantial research indicating that its normal use in food significantly increases the risk of gout [1]. - The amount of purine in commonly used condiments, such as oyster sauce, is very low, and its impact on uric acid levels is minimal compared to high-purine foods [1]. Group 2: Factors Contributing to Gout in Young People - The increase in gout cases among young individuals is attributed to genetics, poor dietary habits (high purine food intake), obesity, and alcohol consumption, particularly beer [2]. - Establishing a scientific lifestyle is crucial for preventing high uric acid levels and gout, rather than fearing specific food components [2]. Group 3: Recommendations for Gout Prevention - Dietary adjustments should include strict limitations on high-purine foods such as organ meats, certain shellfish, and rich broths, along with reduced alcohol intake [2]. - Weight control is essential, but rapid weight loss should be avoided as it may lead to increased ketone bodies, which can inhibit uric acid excretion and trigger acute gout attacks [2]. - Adequate hydration is recommended, with a daily intake of over 2000 milliliters for individuals with normal heart and kidney function to promote uric acid excretion [2][3]. - Regular physical activity, such as aerobic exercises, is beneficial for weight management and metabolic improvement [3]. - High-risk individuals, including those with a family history of gout, obesity, or poor dietary habits, should regularly monitor their blood uric acid levels [4].

Core Viewpoint - Chronic kidney disease (CKD) is a significant and worsening non-communicable disease globally, affecting 8%-14% of adults, leading to increased risks of end-stage kidney disease (ESKD) and cardiovascular events [1][2] Group 1: Disease Impact and Statistics - CKD patients face a significantly increased risk of ESKD and major cardiovascular events, resulting in approximately 2.6 million deaths annually, with 960,000 deaths attributed to ESKD [1] - Hyperuricemia is a common and modifiable complication in CKD patients, with a prevalence twice that of the general population, and its incidence rises sharply with the progression of kidney disease [1][4] Group 2: Research Findings - A recent multicenter real-world study published in "Signal Transduction and Targeted Therapy" demonstrated that urate-lowering therapy (ULT) significantly reduces the risk of kidney function loss and all-cause mortality in CKD patients with hyperuricemia, regardless of gout attacks [2][4] - The study included 269,831 eligible participants, with a primary outcome of composite kidney outcomes defined by a decline in estimated glomerular filtration rate (eGFR) of over 40% or ESKD [5] Group 3: Treatment Outcomes - The cumulative incidence of composite kidney outcomes over three years was 19.69% in the ULT group compared to 23.22% in the control group, indicating a risk difference of -3.53% [5] - The estimated risk differences for ESKD, all-cause mortality, and cardiovascular mortality over three years were -1.88%, -2.25%, and -0.69%, respectively, all favoring the ULT group [5][7]

Group 1 - The core issue of hyperuricemia is a metabolic disorder caused by purine metabolism, with an increasing prevalence of gout among younger populations, indicating a need for attention to abnormal uric acid levels in adolescents [1] - A case study highlights a 19-year-old diagnosed with gout due to a uric acid level of 589 μmol/L, attributed to poor lifestyle choices such as lack of exercise and excessive consumption of sugary drinks [2][3] - Medical professionals indicate that the rise in gout cases among young people is linked to unhealthy dietary habits, lack of physical activity, and other negative lifestyle factors [3][5] Group 2 - The normal fasting blood uric acid levels are defined as above 420 μmol/L for males and above 360 μmol/L for females, categorizing levels above these thresholds as hyperuricemia [7] - For children under 15 years, a blood uric acid level exceeding 357 μmol/L is typically classified as hyperuricemia [9]

Core Insights - The prevalence of gout is increasing, with younger populations, including adolescents, showing abnormal uric acid levels, indicating a growing health concern [1][3] Group 1: Disease Overview - Hyperuricemia is a metabolic disorder caused by purine metabolism disruption, often preceding gout in patients [1] - A case study highlighted a 19-year-old diagnosed with gout due to a uric acid level of 589 μmol/L, attributed to poor lifestyle choices such as lack of exercise and high consumption of sugary drinks [1] Group 2: Contributing Factors - Key factors contributing to gout in adolescents include poor dietary habits, lack of physical activity, and unhealthy lifestyle choices [3] - Consumption of fructose-rich beverages, high-purine foods, and alcohol significantly increases uric acid production [5] Group 3: Health Risks - Hyperuricemia does not equate to gout but poses significant health risks, including the potential for joint inflammation and kidney issues [9] - Elevated uric acid can lead to deposits in organs, causing conditions like kidney stones, uric acid nephropathy, and increased cardiovascular risks due to arterial damage [9] Group 4: Management and Prevention - Management strategies for high uric acid levels include dietary modifications, lifestyle changes, and regular monitoring [11] - Recommendations include reducing intake of high-purine foods, increasing water consumption, maintaining a healthy weight, and ensuring adequate hydration to facilitate uric acid excretion [11]

Core Viewpoint - Gouty arthritis is a common disease closely related to dietary habits, with a higher prevalence in males and a trend towards younger patients [1] Group 1: Disease Overview - Gouty arthritis is characterized by high uric acid levels leading to joint inflammation, commonly affecting males and often starting suddenly with severe pain [5][7] - Symptoms typically peak within 12 hours and may resolve within days or weeks, with over 50% of initial cases occurring in the first metatarsophalangeal joint [5] Group 2: Risk Factors - Key risk factors for gout include excessive alcohol consumption, high-purine diets, and lack of sleep, with sugary drinks particularly harmful for children [5] - Chronic conditions such as chronic gouty nephropathy can arise from uric acid deposits in the kidneys, and high uric acid levels may accelerate atherosclerosis, increasing cardiovascular disease risk [7] Group 3: Prevention and Treatment - Prevention strategies include dietary control, limiting seafood intake, ensuring daily water intake exceeds 2000 milliliters, and avoiding triggers like late nights and intense exercise [9] - During acute attacks, treatment focuses on anti-inflammatory and pain relief methods, while recurrent cases may require long-term uric acid-lowering therapy [9]