Why should gout stop drinking? Is the purine content of wine high?

Gout is an extremely painful disease, and hyperuricemia is not only related to gout attack, but also related to hypertension, diabetes, metabolic syndrome and increased risk of cardiovascular disease.

Therefore, no matter whether gout attacks or not, people with high uric acid gout should strictly manage and control the blood uric acid level.

In addition to the use of drugs, lifestyle has also been put in the first place, repeatedly stressing the need to avoid drinking.

Some people are puzzled by this:

Because uric acid is a product of purine metabolism, wine, especially liquor, does not contain purine. Why does drinking alcohol increase uric acid, especially induce gout attacks?

? Alcohol is the most important risk factor for raising uric acid and inducing gout. It is true that there are many factors leading to hyperuricemia, including obesity, insulin resistance, drinking, diuretic use, hypertension, renal insufficiency, genetic factors and so on.

However, drinking is the most important one.

Because drinking alcohol will cause uric acid metabolism disorder, increase uric acid from several aspects.

Alcohol reduces uric acid excretion. As early as 1960s, some scientists made heavy drinkers who had no history of gout attack drink alcohol, and found that uric acid excretion in urine decreased, thus confirming that alcohol can interfere with uric acid excretion in kidneys.

Later studies confirmed that this interference was caused by high lactic acid in alcohol metabolism, and lactic acid competed with uric acid in the kidney to reduce uric acid excretion.

Alcohol metabolism consumes a lot of ATP and increases the formation of uric acid. Although alcohol itself is not purine, it will not be directly converted into uric acid.

However, in the process of alcohol metabolism, the consumption of biological energy carrier adenosine triphosphate (ATP) is greatly increased, and the production of adenine nucleotide is increased.

We know that adenine nucleotide is one of the raw materials for uric acid synthesis.

This means that alcohol can not be directly converted into uric acid, but it can indirectly increase the raw materials for uric acid synthesis and increase uric acid.

We know that in addition to drinking alcohol, drinking soft drinks containing high fructose is also one of the main risk factors for gout induced by elevated uric acid.

The mechanism is that fructose metabolism, like alcohol, consumes a lot of ATP and increases the raw materials for uric acid synthesis.

? In addition, alcohol can also reduce blood sugar, increase ketone body production, and ketoacidosis can also reduce renal uric acid excretion to some extent.

At the same time, the diuretic effect of alcohol is also related to the increase of serum uric acid caused by alcohol, although the degree is not high.

Not all wines are free of purine. As we know, liquor is distilled liquor, which is an alcoholic aqueous solution produced by distillation and cooling at a temperature higher than the boiling point of alcohol 78.5℃ and lower than the boiling point of water 100℃. It contains almost only alcohol and water in different proportions, and a small amount of evaporable substances.

So in theory, liquor does not contain purine compounds.

This is also confirmed by experimental tests.

For example, a study using a high-sensitivity chromatograph found that the purine content of various wines is as follows: distilled wine (white wine) is 0.7-26.4 micromoles/liter; Ordinary beer (12 malt beer) is 225.0-580.2 micromoles/liter; Low malt beer 193.4-267.9 micromoles/liter; Low malt and low purine beer 13.3 micromoles/liter; Other wines detected ranged from 13. 1 to 8 18.3 micromoles/liter.

Interestingly, the study found that the purine content of some beer and low-alcohol beer is about 2.5 times higher than that of ordinary beer, which should be paid special attention to.

In other words, although liquor does not contain purine (trace purine should be mixed in the blending process).

However, alcohol groups can lead to purine metabolism disorder in vivo through the above-mentioned various ways, which is enough to increase the level of serum uric acid.

Of course, because beer contains quite high purine, drinking beer has a stronger effect on uric acid than liquor, which is the number one risk factor for uric acid increase. All guidelines strongly recommend that patients with hyperuricemia and gout should strictly avoid beer.