When it comes to gout, people often have the impression that they are middle-aged men with paunchy stomachs. In a simple sentence, there are three factors that are prone to gout: obesity, middle (old) age and men.
In fact, as early as ancient times, people found that obese people are prone to gout. However, some friends may wonder, [I am not fat at all, why do I still suffer from gout]?
To this end, Dr. Clove invited Dr. Liu Lei to talk about the relationship between obesity and gout.
This is how obesity induces gout.
Obese people are characterized by high body fat content, which can be divided into subcutaneous fat and visceral fat.
However, visceral fat is more closely related to metabolic diseases. The more visceral fat, the greater the possibility of hyperuricemia and gout.
Excessive visceral fat can affect purine and uric acid metabolism in the body in many ways, including:
- The accumulation of abdominal fat increases the total amount of nucleic acid in metabolism, which leads to an increase in uric acid synthesis. Fat will be decomposed into fatty acids, which will promote the liver to synthesize uric acid and triglyceride and increase blood uric acid and blood lipid. Ketone bodies produced by fatty acid metabolism will reduce kidney excretion of uric acid.
Obesity can lead to gout and hyperuricemia, and according to the type of obesity, we can divide gout patients into three types.
The first type: fat whole body
Obesity is sometimes known at a glance. However, from a medical point of view, obesity needs to be measured by specific values.
This value is the body mass index (BMI), which is currently the most commonly used index in the world. Its algorithm is shown in the following figure:
If the body mass index is less than 18.5, it is underweight. 18.5 ~ 23.9 is normal weight; 24 ~ 27.9 is overweight; More than 28 are obese.
Hyperuricemia is the premise of gout. Many studies at home and abroad show that the higher BMI, the greater the possibility of hyperuricemia.
For gout patients whose body mass index indicates overweight and obesity, weight loss is essential.
The second type: fat belly
Some friends may wonder: I [don’t look fat], body mass index is normal, why is blood uric acid still high? Even gout?
In fact, this kind of [not looking fat] is not really not fat. This part of the people often have a big belly, that is, [abdominal obesity], visceral fat.
As mentioned earlier, visceral fat is the [culprit] that causes high uric acid and gout in obese people. However, in some cases, body mass index cannot show the amount of visceral fat, which needs to be measured by [waist circumference].
Some studies have shown that waist circumference is more closely related to hyperuricemia than body mass index, and waist circumference can also increase the possibility of gout among patients with hyperuricemia.
For men with normal body mass index but waist circumference greater than 90 cm or women with waist circumference greater than 85 cm, weight loss should still be paid attention to.
The third kind: really not fat
In addition to the first two situations, the BMI and waist circumference of some gout patients are within the normal range, especially some young white-collar workers, college students and even minors.
High uric acid and gout are a group of diseases caused by the combined action of genetic factors, lifestyle and environment. Among this group of gout patients, genetic factors may occupy a more important position.
At present, some gene defects have been found, which will affect purine metabolism and uric acid excretion, leading to high uric acid and gout.
Genetic defects cannot be cured, but regular uric acid reduction therapy is still effective and necessary for this group of patients.
Know your body and carry out individualized treatment.
This is the general principle of gout treatment, but the body of each gout patient is different. Know your own body and illness, and under the guidance of doctors, formulate a treatment plan suitable for yourself: the weight loss, the medication, the taboo…….
Only in this way can we have a definite object in view and overcome gout.