饮食在高尿酸血症和痛风中的作用。
Role of diet in hyperuricemia and gout.
机构信息
Yale School of Medicine, New Haven, CT, USA.
Harvard Medical School, Boston, MA, USA; Mount Auburn Hospital, Cambridge, MA, USA.
出版信息
Best Pract Res Clin Rheumatol. 2021 Dec;35(4):101723. doi: 10.1016/j.berh.2021.101723. Epub 2021 Nov 19.
BACKGROUND
Gout is the most common form of inflammatory arthritis, affecting 41 million adults worldwide. The global burden of gout has been increasing over the last three decades, yet its management remains suboptimal. The primary aim of this manuscript is to review the impact of various diets such as the DASH, Mediterranean, and low purine diets; weight loss; and individual foods, including alcohol, caffeine, cherry, dairy, high-fructose corn syrup, omega-3 fatty acids, and vitamin C on hyperuricemia and clinical gout outcomes such as flares and tophi.
CONCLUSION
Few studies to date have specifically evaluated the effect of various dietary approaches on hyperuricemia among people with gout and on gout-specific outcomes. Overall, the dietary factors appear to have a small effect on serum urate levels, and their impact on the long-term clinical course of gout is uncertain. Limited evidence suggests that avoidance of certain foods and beverages may decrease the frequency of gout flares. Weight loss may be beneficial for prevention as well as treatment of gout. Urate-lowering therapy remains the mainstay of therapy, with diet and dietary factors studied to date playing a limited role in the definitive management of gout.
背景
痛风是最常见的炎症性关节炎，影响全球 4100 万成年人。在过去的三十年中，全球痛风负担一直在增加，但管理水平仍然不理想。本文的主要目的是综述各种饮食（如 DASH、地中海和低嘌呤饮食）、减肥以及包括酒精、咖啡因、樱桃、乳制品、高果糖玉米糖浆、ω-3 脂肪酸和维生素 C 在内的个别食物对高尿酸血症和痛风临床结局（如发作和痛风石）的影响。
结论
迄今为止，很少有研究专门评估各种饮食方法对痛风患者血尿酸水平和痛风特定结局的影响。总的来说，饮食因素似乎对血清尿酸水平有较小的影响，其对痛风长期临床病程的影响尚不确定。有限的证据表明，避免某些食物和饮料可能会降低痛风发作的频率。减肥可能对痛风的预防和治疗都有益。降低尿酸治疗仍然是治疗的主要方法，迄今为止，饮食和饮食因素在痛风的确定性治疗中所起的作用有限。
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