Author: Hu Shasha, Shenzhen Hospital of Traditional Chinese Medicine, Nanjing University of Traditional Chinese Medicine
Instructor: Rheumatology Department, Shenzhen Hospital of Traditional Chinese Medicine Zhang Jianyong
Everyone must be familiar with gout
Gout is one of the main diseases of metabolic syndrome
But when it comes to Metabolic syndrome
I’m afraid many people really don’t know what it is
//
In fact it is a precursor to many metabolic diseases. When you understand metabolic syndrome, you will find that it is not far away from us and even exists among you and me.
Gout and metabolic syndrome
"Invisible killer" - obesity
Metabolic syndrome is an important risk factor for the onset of gout. Compared with gout, a series of abnormal signs of metabolic syndrome appear earlier.
The core is insulin resistance, and the primary cause of "insulin resistance" is obesity.
Hypertrophied adipocytes and the inflammatory factors they induce macrophages to secrete can lead to problems with pancreatic islet cell transduction, resulting in insulin resistance, leading to metabolic syndrome. Therefore, gout patients are often accompanied by problems such as diabetes, hypertension, coronary heart disease, and obesity.
In addition, excess energy accumulated in adipose tissue and non-adipose tissues such as the liver leads to metabolic disorders, thereby causing increases in blood pressure, blood sugar, blood lipids and inflammation.
More than 1/3 of gout patients in China are overweight. Because gout patients tend to eat high-fat and high-calorie foods in their daily diet, their body fat content is quite high. Dyslipidemia and obesity affect the excretion of uric acid, which may affect the effect of uric acid-lowering treatment. The two interact with each other and create a vicious cycle, making an unhealthy body even worse.
Life intervention and treatment measures
Poor lifestyle is the culprit of metabolic syndrome. The most important and effective strategy to control metabolic syndrome is to change lifestyle. Losing weight is very important. After weight loss, insulin resistance gradually decreases, which is very beneficial to patients with gout, hypertension, diabetes, etc.
① Control total energy intake and maintain ideal body weight;
② limit fat and cholesterol intake;
③ increase high-quality protein intake and reduce animal protein intake;
④ reasonable intake of carbohydrates ;
⑤ limit salt, increase Potassium and calcium supplement;
⑥ ensure adequate dietary fiber, vitamins and minerals;
⑦ quit smoking and limit alcohol;
⑧ physical exercise, and advocate the use of aerobic exercise;
⑨ In addition to life intervention, drug treatment should be added, under the guidance of professional doctors , targeting various aspects of metabolic syndrome, such as lowering blood pressure, lowering blood sugar, lowering lipids, lowering uric acid, etc.
Reference:
1. Ying W, Fu W, Lee Y S, et al. The role of macrophages in obesity-associated islet inflammation and β-cell abnormalities [J]. Nat Rev Endocrinol, 2020, 16(2): 81- 90.10.1038/s41574-019-0286-3.
2.Kim HL, Chung J, Kim KJ, Kim HJ, Seo WW, Jeon KH, et al. Lifestyle Modification in the Management of Metabolic Syndrome: Statement From Korean Society of CardioMetabolic Syndrome (KSCMS). Korean Circ J 2022; 52(2):93-109 .
3.Perez-Martinez P, Mikhailidis DP, Athyros VG, Bullo M, Couture P, Covas MI, et al. Lifestyle recommendations for the prevention and management of metabolic syndrome: an international panel recommendation. Nutr Rev 2017;75(5):307-326.
4. Zhu Y, Pandya B, Choi H. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007-2008. The American journal of medicine 2012; 125(7):679-687.e671.
