"The 'High Uric Acid' Crisis Affecting Young People"
"Hey! You're going to have a problem"
Uric acid 480 - In 2022, Chengzhou, a 25-year-old who had just been working for one year, received this regular physical examination report.
Whether male or female, if the fasting blood uric acid level exceeds 420 μmol/L on two non-consecutive days, it can be diagnosed as "hyperuricemia". Not long after entering the workplace, his body had an additional abnormal indicator.
Medically speaking, this is not a big problem. When it comes to high uric acid, everyone always thinks of gout, but in fact, the two cannot be equated. Gout is an inflammation caused by the deposition of urate crystals, a metabolic waste, in the local joints due to excessive purines in the body - once it develops into gout, the situation is irreversible. Gout will follow a person for a lifetime, cannot be cured, and can only be controlled and alleviated.
But Chengzhou did not have a gout attack or kidney function disease, and there was no pain in his body. Those like him who have no actual physical sensation are called "asymptomatic hyperuricemia", and the uric acid that cannot be metabolized still remains in the blood and has not turned into crystals.
According to the "2021 China Hyperuricemia and Gout Trend White Paper", there are about 177 million people with hyperuricemia in China, with an overall prevalence rate of 13.3%, while the overall incidence of gout is only 1.1%. He calculated that the proportion of gout in the hyperuricemia group is about 10%, which sounds like the risk is not that high.
Director Zhou Fude of Peking University First Hospital told "Post-Wave Research Institute", If there is no gout attack and the uric acid is lower than 700, it is not recommended to come to the hospital for special treatment. Adjusting the diet and controlling with regular exercise is sufficient.
The danger is still in its infancy and can be nipped in the bud.
As for the reason for the increase in uric acid, Chengzhou is very clear in his heart. In just one year of work, he gained weight from a healthy young man of around 140 pounds to 160 pounds. As a product manager of a large factory in Shanghai, his routine is to go to work at 10 o'clock, get off work at 22 o'clock, and stay up until the middle of the night twice a week, with an average of only 6 hours of sleep per day.
Staying up late, emotional stress, and then releasing stress through overeating, this result is quite reasonable. But at that time, he was too busy at the beginning of his career to even care about his body, "In life, except for work, everything else seems to take a back seat."
He didn't pay much attention to this abnormality.
The panic began in the second year. During this physical examination, his weight had increased to 180 pounds, and his uric acid had soared to 552. It seems to be tied to weight, and the uric acid has significantly increased like a roller coaster. In addition, there are several more abnormalities on the physical examination report: the alanine aminotransferase exceeds the standard, and fatty liver appears.
These concomitant phenomena make him even more afraid - this means that his kidney and liver function indicators have problems, and the comprehensive metabolism is abnormal, "Anyway, something is wrong everywhere". Originally, the initial increase in uric acid was just an early warning of a series of subsequent dangers.
Just as Dr. David Perlmutter, an American neuroscientist, described in "Crazy Uric Acid", Hyperuricemia is the "fourth high" among the "three highs", "Uric acid is an insignificant and seriously underestimated metabolite, but it has an astonishing connection with the overall health of the human body."
The impact of uric acid is seriously underestimated.
Young people who turn a blind eye to this may continue to have a rising uric acid level after continuous indulgence, and other diseases with even more serious harm may occur. According to the "Chinese Expert Consensus on the Treatment of Hyperuricemia and Gout", hyperuricemia is closely related to type 2 diabetes, hypertension, cardiovascular diseases, chronic kidney diseases, gout and other diseases.
A netizen on Xiaohongshu shared her story: One night, she suddenly felt a severe stomach pain, went to the hospital for a CT scan, and found two stones in the ureter. After the operation, she reviewed her past lifestyle and thought that her uric acid had been exceeded in the annual physical examination. Crystals (that is, stones) are more likely to be produced in a high uric acid environment. Then she went to the endocrinology specialist to put controlling uric acid on the agenda.
An advertising industry practitioner provided another case. One of her female colleagues born in 1993 does not drink alcohol or eat much meat, but she loves to eat sweets, is overweight, and her uric acid has been continuously higher than 500. Later, she had a more difficult problem to solve - thyroid cancer.
Of course, uric acid is by no means the culprit for all this. There is no direct causal relationship between uric acid and these diseases. It is only a biomarker.
In many studies, uric acid is gradually regarded as a new marker of "metabolic syndrome". This term may rarely be mentioned, but you must know more or less about the five key characteristics of "metabolic syndrome": high blood pressure, excessive blood sugar, excessive fat in the waist, excessive triglycerides (a type of blood lipid), and abnormal cholesterol levels.
Now it sounds like the problem is gradually getting serious, doesn't it?
Uric acid, which was previously regarded as a "harmless" metabolic waste, is an early warning of a metabolic syndrome. After experiencing a climb in uric acid, many people heard this continuous alarm from the body: "Hey, you're going to have a problem."
"There is no precise portrait"
Three years ago, when Han Yingzi went for a physical examination, her uric acid was 10 points higher than the normal value (the reference range of the normal value of uric acid for women is 357, which is lower than that for men). It was not a big problem.
But after she spent another year with three meals a day filled with fast food, convenience food, and self-heating hot pots, and basically no regular exercise, her uric acid level soared to 450 - at that time, she was just a 26-year-old girl.
Han Yingzi was very surprised that she was entangled by "uric acid" at a young age.
In the general perception, gout, which is directly related to high uric acid, is more common in older men. Because women's estrogen can promote the excretion of uric acid by the kidneys, the prevalence of gout in men is about three times that in women, and the gap begins to narrow significantly after women menopause.
Obviously, "Women don't need to worry about uric acid" is a blatant lie. The uric acid crisis is becoming younger and attacking everyone indiscriminately. According to a hyperuricemia prevalence trend study involving more than 2 million people, from 2001 to 2017, The population with hyperuricemia in China jumped from 8.5% to 18.4%, equivalent to 3 out of every 20 people having high uric acid. Among them, nearly 60% are young people aged 18-35. (Li Y, Shen Z, Zhu B, Zhang H, Zhang X, Ding X. Demographic, regional and temporal trends of hyperuricemia epidemics from 2000 to 2019.)
Chengzhou also did not expect that he would become a "uric acid blogger".
After being diagnosed with a high uric acid value of 550 two years ago, he chose to resign and return to his hometown in Zhejiang with his wife. At that time, his wife was pregnant, and both he and his wife were working in a 996 rhythm, "It just felt like this wouldn't work." After returning to the second-tier city, with a slower pace of life, he had more leisure time and also had the leisure to formulate a uric acid reduction plan for himself.
He posted his experience in reducing uric acid on social media, and it suddenly became a popular post. The topic of uric acid received more attention than imagined. On Xiaohongshu, the tag #uric acid has 150 million views.
After receiving many help-seeking posts from netizens, He was surprised by the complexity of the hyperuricemia group, and even found it difficult to make a precise portrait. Similar cases are as follows:
A girl in her early 20s, who does not eat seafood or drink beer, and can also ensure a 2000ml water intake every day, has a uric acid value of more than 400;
A big brother who loves fitness, has a good figure, loves sports, often goes to the gym, and eats protein powder. It is guessed whether excessive exercise leads to high uric acid;
A pregnant mother who is 5 months pregnant suspects that pregnancy affects the increase in uric acid;
A parent of a junior high school child said that the child's uric acid exceeded the standard after entering junior high school and is helping him control it...
"They are very anxious, as if they regard me as a confidant." Shocked by everyone's strong reaction, Chengzhou, who has a bachelor's degree in statistics, also consulted many papers through Google Scholar to figure out the secret of uric acid.
It must be clear that the cause of high uric acid is comprehensive and cannot be simply attributed to a certain aspect.
First of all, genes are a mysterious thing. If there is a family history of gout or a pathological cause in a family member, he certainly cannot solve it. But after studying this "insignificant" biostatistical indicator, he found that the high uric acid population who came to him to pour out their troubles could basically find some traces of causes in their acquired lifestyle - and it is nothing more than diet and exercise.
Let's talk about diet first. Purine, alcohol, and fructose are the three major sources of uric acid. Quitting alcohol and reducing the intake of high-purine foods are the most direct reactions of everyone, and there is no need to elaborate. But the item of fructose has rarely been noticed in the past.
When encountering a girl with normal weight but high uric acid, Chengzhou would first ask, "Do you love to eat sweets? Love to drink milk tea and beverages?" The results are almost the same.
Many people have ignored the harm caused by fructose. In 2019, a study involving 154,000 people published in the "British Medical Journal" showed that there is a strong correlation between drinking sugary beverages and increased uric acid and gout levels. Even if fructose syrup is consumed at a healthy weight, it can lead to problems of metabolic disorders and weight imbalances.
Milk tea, sugary beverages, and even freshly squeezed juices contain a lot of fructose. Han Yingzi, who has now reduced her uric acid from 450 to 305, also particularly emphasizes the need to be vigilant about a "health scam" marketed by businesses - concentrated juice, "Juice is even more terrifying than milk tea (the kind of fresh milk tea without non-dairy creamer)."
This former loyal fan of NFC juice has completely given up this drink. Han Yingzi later studied the ingredient list of the juice, "It just writes concentrated orange juice, concentrated grape juice and water, but these 'concentrated' juices already contain a lot of additives, but it doesn't list them specifically for you."
Similarly, freshly squeezed juice also contains a lot of fructose and should not be consumed in excessive amounts. But studies have shown that eating whole fruits is not correlated with the onset of gout. The reason may be that the nutrients and other health-beneficial substances in fruits, such as potassium, flavonols, dietary fiber, and vitamin C, can counteract or neutralize the increase in uric acid levels.
Low-calorie drinks that Han Yingzi shared on social media during the weight loss period
Let's talk about exercise. Many people have a cognitive blind spot: Exercise can lead to an increase in uric acid levels - because uric acid can only be excreted through urine, and exercise increases sweating, water is evaporated through sweat, and urine output is reduced; in addition, fitness enthusiasts consume more high-purine foods such as chicken breast, and these multiple reasons can stimulate an increase in uric acid.
Excessive exercise may indeed lead to an increase in uric acid levels. Therefore, some people who start to control uric acid tend to do less anaerobic exercise and only enhance the metabolic system through aerobic exercise.
This is simply "giving up eating for fear of choking". Dr. Zhou Fude told "Post-Wave Research Institute", "All kinds of exercises that consume a lot of energy can cause high uric acid, because more uric acid is produced, but if you drink more water, it's okay, so exercise should still be done."
After reading a large number of literature and the cases of help-seeking from Xiaohongshu netizens, Chengzhou also found that "If you really want to make a portrait of the hyperuricemia population, most of them are obese."
A sampling data of the Chinese hyperuricemia population covering more than 31,000 people shows that among the population with drinking habits, the proportion of the hyperuricemia population is 28.1%, but In the group with a BMI over 30, the hyperuricemia rate is 47.8%. Obesity is a significant risk factor. (Bin G, Jie Z, Jiapu G, et al.)