Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis Rheumatol. 2021 Jun;73(6):1014-1020. doi: 10.1002/art.41614. Epub 2021 Apr 23.
To determine whether the Dietary Approaches to Stop Hypertension (DASH) diet or an alternative, simplified diet, emphasizing high-fiber fruits and vegetables (the FV diet), lowers serum urate levels.
We conducted a secondary study of the DASH feeding study, a 3-arm, parallel-design, randomized trial of 459 adults with systolic blood pressure (BP) of <160 mm Hg and diastolic BP of 80-95 mm Hg, who were not receiving BP medications. Participants were randomized to receive 8 weeks of monitored feeding and ate 1 of 3 diets: 1) a typical American diet (control), 2) the FV diet, a diet rich in fruits and vegetables but otherwise similar to the control diet, or 3) the DASH diet, which was rich in fruits, vegetables, and low-fat dairy products, and reduced in fat, saturated fat, and cholesterol. Body weight was kept constant throughout the study. Serum urate levels were measured at baseline and after 8 weeks of feeding.
For the 327 participants with available specimens (mean ± SD age 45.4 ± 11.0 years, 47% women, 50% African American), the mean ± SD baseline serum urate level was 5.7 ± 1.5 mg/dl. Compared to the control diet, the FV diet reduced the mean serum urate level by 0.17 mg/dl (95% confidence interval [95% CI] -0.34, 0.00; P = 0.051) and the DASH diet reduced the mean serum urate level by 0.25 mg/dl (95% CI -0.43, -0.08; P = 0.004). These effects increased with increasing baseline serum urate levels (<5, 5-5.9, 6-6.9, 7-7.9, and ≥8 mg/dl) for those receiving the DASH diet (a reduction of 0.08, 0.12, 0.42, 0.44, and 0.73 mg/dl, respectively; P for trend = 0.04), but not for those receiving the FV diet.
Our findings indicate that the DASH diet reduces serum urate levels, particularly among those with hyperuricemia. These findings support the growing need for a dedicated trial to test the DASH diet among patients with hyperuricemia and gout.
确定采用限制钠的得舒饮食（DASH）或另一种强调高纤维水果和蔬菜的简化饮食（FV 饮食），是否可以降低血清尿酸水平。
我们对 DASH 喂养研究进行了二次研究，该研究是一项 3 臂、平行设计、随机试验，共纳入 459 名收缩压（BP）<160mmHg 和舒张压（BP）80-95mmHg 的成年人，这些患者未服用降压药物。参与者随机接受 8 周的监测喂养，并食用 3 种饮食之一：1）典型的美国饮食（对照），2）FV 饮食，一种富含水果和蔬菜但与对照饮食相似的饮食，或 3）DASH 饮食，富含水果、蔬菜和低脂乳制品，并减少脂肪、饱和脂肪和胆固醇。整个研究期间保持体重不变。在基线和 8 周喂养后测量血清尿酸水平。
在 327 名有可用标本的参与者中（平均±标准差年龄 45.4±11.0 岁，47%为女性，50%为非裔美国人），平均±标准差基线血清尿酸水平为 5.7±1.5mg/dl。与对照饮食相比，FV 饮食使平均血清尿酸水平降低 0.17mg/dl（95%置信区间 [95%CI] -0.34，0.00；P=0.051），DASH 饮食使平均血清尿酸水平降低 0.25mg/dl（95%CI -0.43，-0.08；P=0.004）。对于接受 DASH 饮食的参与者，这些影响随着基线血清尿酸水平的增加而增加（<5、5-5.9、6-6.9、7-7.9 和≥8mg/dl）（分别降低 0.08、0.12、0.42、0.44 和 0.73mg/dl；P 趋势=0.04），但对于接受 FV 饮食的参与者则不然。
我们的研究结果表明，DASH 饮食可降低血清尿酸水平，尤其是在高尿酸血症患者中。这些发现支持需要专门的试验来测试 DASH 饮食在高尿酸血症和痛风患者中的应用。
