The main cause of gout

There are many causes of gout. It has certain genetic factors, which are related to congenital reasons. In addition, acquired reasons are also relatively important. For example, if a person is too obese, this is a very dangerous factor in inducing gout. Regular drinking and excessive drinking can also easily lead to the occurrence of gout. Other chronic nasal diseases, such as high blood pressure and diabetes, are also prone to cause gout.

The main causes of gout

1. Obesity

Obesity is a risk factor for gout. Obesity not only increases the risk of gout, but also causes gout in obese patients at an earlier age. As BMI increases, the incidence of gout increases significantly, and visceral fat is also closely related to the occurrence of gout.

Hypertriglyceridemia and obesity are both risk factors for gout. Obesity can lead to insulin resistance, which ultimately leads to reduced renal excretion of uric acid through multiple pathways. Obesity can cause an increase in free fatty acids, which in turn increases the synthesis of uric acid by affecting the activity of xanthine oxidase and other enzymes.

2. Drinking

Excessive alcohol intake is an independent risk factor for gout attacks. Beer contains a large amount of purine, so it has the greatest risk of inducing gout.

Possible reasons why drinking alcohol may increase blood uric acid levels:

(1) Ethanol stimulates the body to synthesize lactic acid, which competitively inhibits renal tubular uric acid secretion.

(2) Ethanol can promote uric acid production by increasing the degradation of ATP into adenosine monophosphate.

(3) Certain alcoholic beverages, especially fermented beverages such as beer, produce a large amount of purine during the fermentation process. Long-term and excessive drinking can promote the occurrence of HUA and even gout.

3. Hypertension

The serum uric acid level and the prevalence of HUA in patients with hypertension were significantly higher than those in non-hypertensive patients. Hypertension is an independent risk factor for gout attacks. A nine-year follow-up of U.S. residents found that participants with hypertension had a significantly higher risk of developing gout than those without hypertension. The possible reasons are: hypertension causes microvascular lesions, resulting in tissue hypoxia, followed by an increase in blood lactate levels, which inhibits the secretion of urate in the renal tubules, and ultimately causes uric acid retention and HUA; in addition, many hypertensive patients use diuretics for a long time, and loop diuretics and thiazide diuretics can promote an increase in blood uric acid levels.

4. High blood sugar

Hyperglycemia Hyperglycemia is a risk factor for HUA. Diabetic patients have enhanced purine catabolism, increased uric acid production, and elevated blood uric acid levels. HUA can aggravate kidney damage, reduce renal uric acid excretion, and further aggravate the occurrence and development of HUA. However, changes in blood glucose and blood uric acid levels are not linearly correlated.

5. Foods rich in purine

Foods rich in purine (such as meat and seafood) may increase the risk of HUA/gout. Fructose is a carbohydrate that can increase blood uric acid levels, promote uric acid synthesis, and inhibit uric acid excretion. Therefore, large intake of fructose-containing beverages can increase blood uric acid levels.

6. Certain drugs

Many drugs are closely related to HUA. The relative risks of gout for loop diuretics and thiazide diuretics were 2.64 and 1.70, respectively. Low-dose aspirin (75-150 mg/d), cyclosporine, tacrolimus and pyrazinamide can promote the increase of blood uric acid and increase the risk of gout.