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regulates · 4
When the liver breaks down fructose rapidly it uses up a lot of ATP, and the breakdown products end up as uric acid. Choi 2008 followed 46,393 men (a cohort study): those drinking two or more servings of sugar-sweetened soft drinks a day had an 85% higher risk of gout than those who almost never drank them; Choi 2010 found a similar association in women, and for orange juice as well. Whole fruit, eaten slowly and in smaller amounts, carries a much less clear risk than sugary drinks.
Alcohol raises uric acid in two ways: the lactate produced while metabolizing alcohol competes with uric acid for the kidney's excretion route, so less uric acid is cleared, and beer itself carries a fair amount of purines. In Choi 2004's cohort of men, beer had the strongest association with gout, spirits came next, and moderate wine showed no association (an observational study).
A joint that suddenly turns red, hot and swollen is a different problem from wear and tear: urate crystals falling into the joint space set off acute inflammation. An attack like this needs a prompt medical visit to tell gout apart from a joint infection.
Uric acid stones are one type of kidney stone, and people with gout are clearly more likely to form them than others; acidic urine and high uric acid are the common ground of both. Urate-lowering drugs such as allopurinol and febuxostat are used both to treat gout and to prevent uric acid stones.
contrast · 1
High uric acid on a lab report is not gout: high blood urate by itself causes almost no symptoms, and most people with it never have an attack. Among adults in China, about 13% have high urate and about 1% have gout. Treating it as gout on the way, with strict food restrictions and repeated clinic visits, is the most common overreaction.