Dietary and Lifestyle-Centered Approach in Gout Care and Prevention.
Dietary and Lifestyle-Centered Approach in Gout Care and Prevention.
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DOI：
10.1007/s11926-021-01020-y
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发表时间：
2021-07-01
影响因子：
5
通讯作者：
Choi HK
中科院分区：
文献类型：
--
作者：
Yokose C;McCormick N;Choi HK
我们的目标是对现有文献进行全面综述，为痛风和高尿酸血症患者提供饮食建议，这些建议有可能同时降低血清尿酸和减少痛风发病率，同时全面解决痛风的心脏代谢合并症。痛风的全球负担正在世界范围内不断增加，特别是在发达国家和女性中。通常建议痛风患者遵循低嘌呤（即低蛋白质）饮食以避免嘌呤负荷。然而，这种方法可能会导致不健康的碳水化合物和脂肪的消耗增加，进而导致代谢综合征，随后提高血清尿酸水平并导致不良的心血管后果。另一方面，几种行之有效的心脏代谢健康饮食，例如地中海饮食和高血压预防饮食 (DASH) 饮食，与超重或肥胖者的减肥相结合，也对相关痛风终点产生有益影响。重要的是不仅要认识到饮食对高尿酸血症和痛风的直接影响，而且要认识到其通过肥胖和胰岛素抵抗产生的介导作用。因此，几种卓越的健康饮食模式已被证明对心脏代谢健康有益，不仅能全面解决痛风发病问题，还能解决导致痛风患者过早死亡的相关合并症。
We aim to provide a comprehensive review of the available literature to inform dietary recommendations for patients with gout and hyperuricemia that have the potential to simultaneously lower serum urate and reduce gout morbidity while addressing gout’s cardiometabolic comorbidities holistically. The global burden of gout is rising worldwide, particularly in developed nations as well as in women. Patients with gout are often recommended to follow a low-purine (i.e., low-protein) diet to avoid purine-loading. However, such an approach may lead to increased consumption of unhealthy carbohydrates and fats, which in turn contributes to metabolic syndrome and subsequently raises serum urate levels and leads to adverse cardiovascular outcomes. On the other hand, several well-established diets for cardiometabolic health, such as the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets, in combination with weight loss for those who are overweight or obese, also have beneficial effects on relevant gout endpoints. It is important to recognize not only the direct effect of diet on hyperuricemia and gout, but its mediated effect through obesity and insulin resistance. Thus, several preeminent healthy dietary patterns that have proven benefits in cardiometabolic health have the power to holistically address not only gout morbidity but also its associated comorbidities that lead to premature mortality among patients with gout.
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