Ankli Barbara
Rheumazentrum Basel Dr. med. B. Ankli, Basel.
Medizinische Fakultät Universität Basel.
Ther Umsch. 2024 Sep;81(5):164-167. doi: 10.23785/TU.2024.05.005.
Gout, the most common arthritis worldwide, is closely linked to cardiovascular disease and metabolic syndrome. The most impor-tant risk factor for developing gout is hyperuricemia. Serum uric acid is the end product of purine metabolism and can be partially influenced by dietary changes. Since a quarter of serum uric acid is excreted via the intestine, there is also a connection with diet here - keyword microbiome. Recently, genetic predispositions and drug therapy for gout have come to the fore. However, since cardiovascular comorbidities exist in high frequency, a dietary adjustment also makes sense to improve the comorbidities. Recently, the focus has shifted away from simply reducing purine intake in favor of introducing a largely plant-based diet. Reducing alcohol consumption makes sense for many reasons but does not lead to a significant reduction in serum uric acid. In addition to drug therapy, however, all possibilities should be exploited to enable a rapid reduction in serum uric acid to the target range; a change in diet can contribute to this. A change in diet can also have a positive effect on the frequency of gout flares. Targeted, structured information for patients promotes their knowledge of the disease and motivation to achieve their serum uric acid (SUA) goal. The right diet may be the personal contribution to quickly reaching the SUA target level and freedom from gout flares.
痛风是全球最常见的关节炎，与心血管疾病和代谢综合征密切相关。发生痛风最重要的危险因素是高尿酸血症。血清尿酸是嘌呤代谢的终产物，可部分受饮食变化影响。由于四分之一的血清尿酸通过肠道排泄，因此这里也存在与饮食的关联——关键词是微生物群。最近，痛风的遗传易感性和药物治疗受到关注。然而，由于心血管合并症的发生率很高，进行饮食调整对改善合并症也有意义。最近，关注点已从单纯减少嘌呤摄入转向采用主要以植物为基础的饮食。减少酒精摄入有诸多原因，但不会导致血清尿酸显著降低。然而，除药物治疗外，应利用一切可能手段使血清尿酸迅速降至目标范围；饮食改变有助于实现这一点。饮食改变对痛风发作频率也可能产生积极影响。为患者提供有针对性、有条理的信息可增进他们对疾病的了解以及实现血清尿酸（SUA）目标的动力。正确的饮食可能是个人对快速达到SUA目标水平和免受痛风发作之苦的贡献。
