What causes high uric acid levels

Elevated uric acid levels may be caused by dietary factors, metabolic abnormalities, renal excretion disorders, drug effects, genetic factors, and other factors.

1. Dietary factors:

A high purine diet is a common cause of elevated uric acid levels. Animal organs, seafood, thick meat soup and other foods have high purine content, and excessive intake can increase the purine metabolite uric acid in the body. Alcohol, especially beer, can inhibit kidney excretion of uric acid and accelerate purine breakdown. Long term high sugar diet may also indirectly affect uric acid metabolism through insulin resistance.

2. Metabolic abnormalities: Obese individuals often have insulin resistance, which reduces the excretion of uric acid by the kidneys. The activity of xanthine oxidase increases in patients with metabolic syndrome, accelerating the conversion of purine to uric acid. Ketones produced by fat breakdown during rapid weight loss competitively inhibit uric acid excretion, leading to temporary elevation of uric acid.

3. Renal excretion disorders:

When renal dysfunction occurs, the glomerular filtration rate decreases and uric acid excretion decreases. Some renal tubular diseases can affect the reabsorption and secretion of uric acid. Dehydration causes urine to concentrate, reducing the solubility of uric acid and making it easier to form crystals, which in turn affects excretion.

4. Drug effects:

Diuretics such as hydrochlorothiazide can reduce uric acid excretion. Immunosuppressant cyclosporine can alter renal tubular transport function. The anti tuberculosis drug pyrazinamide can interfere with the secretion of uric acid in renal tubules. Long term use of low-dose aspirin can also mildly inhibit uric acid excretion.

5. Genetic factors:

Primary hyperuricemia is often associated with genetics, such as hypoxanthine guanine phosphoribosyltransferase deficiency. Familial adolescent hyperuricemia nephropathy is an autosomal dominant genetic disease. Certain genetic polymorphisms can affect the function of uric acid transporters, leading to abnormal renal excretion.

Controlling uric acid needs to start with lifestyle, drinking more than 2000 milliliters of water per day to promote excretion, choosing low purine foods such as eggs, milk, and fresh vegetables, and limiting the intake of animal organs and seafood. Moderate aerobic exercise can help improve metabolism, but vigorous exercise should be avoided from triggering gout attacks. Obese individuals need to gradually lose weight, with a monthly weight loss of no more than 4 kilograms. Regularly monitor blood uric acid levels, and when males exceed 420 μ mol/L or females exceed 360 μ mol/L, it is recommended to undergo medication intervention under the guidance of a doctor. When combined with chronic diseases such as hypertension and diabetes, attention should be paid to drug interaction, and drugs that affect uric acid metabolism should be avoided.