近日，浙江一位40岁男性痛风患者，因连续一周饮用街边贡丸汤引发膝盖剧痛就医，经医生检查确诊为终末期肾病（尿毒症期）。 在众多高嘌呤食物中，海鲜、牛肉、动物内脏等是高尿酸人群的首要"避雷目标"，摄入过多可能诱发尿酸升高，痛风发作。 临近春节，聚会聚餐增多，大鱼大肉轮番上桌，各种海鲜、红肉、糖果、糕点琳琅满目。年味拉满的同时也暗藏着健康隐患。一不小心贪嘴多吃，体内的 尿酸就可能悄然飙升，给健康添了不必要的负担。 引援人民日报健康客户端消息，《2021中国高尿酸及痛风趋势白皮书》数据显示，目前我国高尿酸血症总体患病率为13.3%，患病人数约1.77亿。按我国 14.1亿人口计算，平均每8个人里就有1人是高尿酸血症。 继高血压、高血糖、高血脂这"三高"后，高尿酸已经成了威胁健康的"第四高"。 尿酸危机席卷全国 近年来，患高尿酸血症的人越来越多。2021年一项覆盖200余万人、整合177项研究的分析显示：2001年，中国大陆15岁以上人群的高尿酸血症患病率仅为 8.5%，截至2017年这一比例已升至18.4%，16年间涨幅超一倍。 高尿酸血症还呈现出年轻化趋势。一项针对54580名青少年儿童的汇总研究表明，我国3-19 ...

痛风发作时的剧痛让患者坐立难安，但不少人疼过就忘，压根儿不把尿酸控制当回事。"医生，我痛风 能治好吗？"北部战区总医院风湿免疫科主任李萍介绍，在门诊最常听到这样的疑问。痛风从来不是简 单的关节疼痛，更是身体代谢紊乱发出的"红色警报"，只有科学应对、长期坚持调理，才能避免肾脏、 心脑血管跟着遭殃。 李萍主任表示，高尿酸血症是痛风的重要发病前提，但并非所有高尿酸人群都会发展为痛风，临床上仅 有约5%～12%的高尿酸血症患者会出现痛风症状。首次发作的痛风患者，建议在症状缓解后4周左右复 查血尿酸，必要时做关节、肾脏超声排查尿酸盐结晶，有不适需及时就诊。这类患者无需急于用药，优 先通过饮食控制，血尿酸通常能下降60umol/L左右，若控制得当，下次发作可能间隔两年。痛风患者血 尿酸控制目标因人而异：单纯预防发作需低于360umol/L；形成痛风石或合并痛风性肾病者，需严控在 200-300umol/L；第二次发作后，则要在医生指导下长期服降尿酸药，切勿自行停药或调剂量。 痛风不只是关节痛，更是代谢失衡的"信号灯"，常与高血脂、高血压、高血糖相伴，形成"代谢综合 征"连锁反应。长期不规范治疗，不仅会引发痛风性肾病，出现 ...

Core Viewpoint - The prevalence of hyperuricemia among the Chinese population has significantly increased, with rates rising from 8.5% in 2001 to 18.4% in 2017, indicating a public health concern that requires attention [4][6][10]. Summary by Sections Prevalence of Hyperuricemia - A study involving over 2 million participants revealed that the prevalence of hyperuricemia in mainland China for individuals aged 15 and above increased from 8.5% in 2001 to 18.4% in 2017, more than doubling in less than two decades [6][10]. - A national survey in 2022 estimated the overall prevalence of hyperuricemia among adults aged 18-59 to be 15.1%, suggesting that 1 in 20 adults is affected [6]. Regional Differences - The prevalence of hyperuricemia varies significantly across different regions in China, with the southern regions, particularly Guangdong, showing the highest rates at 42.2% [7][9]. - The study categorized mainland China into seven regions, with hyperuricemia rates of 25.5% in South China and 21.2% in Southwest China [7]. Contributing Factors - The increase in uric acid levels is attributed to various factors, including genetic predisposition, lifestyle changes, and dietary habits [12][15]. - Genetic studies indicate that 25% to 60% of the variance in uric acid levels can be attributed to hereditary factors, with specific genes identified in the Han Chinese population that may contribute to hyperuricemia [16][17]. Dietary Influences - Certain foods, particularly those high in purines, such as seafood, red meat, and alcohol, are linked to increased uric acid levels. The consumption of animal products has risen significantly, with a 33% increase in seafood consumption over the past decade [21][22]. - The intake of red meat and sugary beverages has also increased, with red meat consumption rising by 134.3% since 2002, contributing to higher hyperuricemia risks [22]. Lifestyle Factors - Insufficient hydration and lack of physical activity are common issues, with over one-third of adults not meeting the recommended daily water intake and a rising percentage of adults engaging in inadequate physical activity [23][24]. - The lifestyle changes, including increased consumption of high-purine foods and decreased physical activity, are believed to exacerbate the hyperuricemia epidemic [24]. Societal Implications - The rising levels of uric acid and associated health issues reflect broader societal trends, including aging populations and changing dietary patterns, necessitating public health interventions [50][52]. - Addressing hyperuricemia requires a multifaceted approach, including dietary modifications, increased physical activity, and potential medical interventions for those at risk [50].

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 ...

Core Viewpoint - The article emphasizes the importance of managing uric acid levels carefully, highlighting that rapid reduction can lead to severe health issues, including acute gout attacks and kidney damage. Group 1: Uric Acid Management - Over 150 million people in China suffer from hyperuricemia, with more than 15 million diagnosed with gout [1] - Rapidly lowering uric acid can exacerbate joint pain and swelling due to the instability of urate crystals in the joints [3][4] - A stable reduction in uric acid levels is recommended, ideally decreasing by 60 to 120 micromoles per liter each month to avoid acute gout attacks and protect kidney and cardiovascular health [5] Group 2: Medication Guidelines - Medication is suggested when uric acid levels exceed 420 micromoles per liter for men and postmenopausal women, and 360 micromoles per liter for premenopausal women [6] - For asymptomatic patients with uric acid levels below 480 micromoles per liter, lifestyle changes are preferred over immediate medication [8] - If uric acid exceeds 540 micromoles per liter, medication should commence regardless of gout symptoms [9] Group 3: Lifestyle Recommendations - Limiting high-purine foods, such as certain seafood and organ meats, is crucial for managing uric acid levels [11] - Staying hydrated with 2000 to 3000 milliliters of water daily is recommended, avoiding sugary drinks and alcohol [12] - Reducing fructose intake is advised as it can increase uric acid production and decrease its excretion [14] - Regular exercise and maintaining a healthy weight can help prevent complications associated with high uric acid levels [16][17] - Keeping warm during colder months is important to prevent uric acid crystallization in joints [18][19]

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]