Нефармакологічний та харчовий менеджмент подагри: поточні й майбутні напрямки

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Опубліковано: гру 28, 2019
DOI: https://doi.org/10.30841/2307-5112.5-6.2019.194833
Ключові слова:
подагра, гіперурикемія, сечова кислота, продукти харчування, пурини, фруктоза, дієта, маса тіла, спосіб життя,

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І. Ю. Головач
Клінічна лікарня «Феофанія» Державного управління справами, Україна
https://orcid.org/0000-0002-6930-354X
Є. Д. Єгудіна
Клініка сучасної ревматології, Україна
https://orcid.org/0000-0001-8702-5638

Анотація

Подагра – це запальний артрит, спричинений відкладенням кристалів моноурату натрію у синовіальних суглобах і м’яких тканинах. Поточні рекомендації акцентують увагу насамперед на агресивній медикаментозній терапії для лікування подагри. Водночас рекомендаціям щодо зміни способу життя і відповідного харчування приділено менше уваги. У даному літературному огляді наведено ретельний аналіз впливу способу життя, окремих продуктів харчування і компонентів їжі на ризик розвитку гіперурикемії, подагри та її клінічних проявів, виходячи з останніх рекомендацій та проведених досліджень. Розглянуто механізми, що лежать в основі впливу особливостей певних продуктів на рівень сироваткової сечової кислоти. Наголошено на важливості дієтичного консультування пацієнтів при подагрі, необхідності контролю маси тіла і регулярних помірних фізичних навантажень задля поліпшення прогнозу перебігу цього захворювання.

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Як цитувати
Головач, І. Ю., & Єгудіна, Є. Д. (2019). Нефармакологічний та харчовий менеджмент подагри: поточні й майбутні напрямки. Сімейна Медицина, (5-6), 129–137. https://doi.org/10.30841/2307-5112.5-6.2019.194833
Номер
№ 5-6 (2019)
Розділ
Внутрішні хвороби
Авторське право (c) 2020 І. Ю. Головач, Є. Д. Єгудіна

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Біографії авторів

І. Ю. Головач, Клінічна лікарня «Феофанія» Державного управління справами

Головач Ірина Юріївна,

керівник центру ревматології

Є. Д. Єгудіна, Клініка сучасної ревматології

Єгудіна Єлизавета Давидівна

Посилання

Головач І.Ю. Єгудіна Є.Д. Подагра: стара знайома в рамках сучасних рекомендацій // Практикуючий лікар. – 2019. – Т. 8, № 2. – С. 9-27.

Abdelmalek M.F., Lazo M., Horska A., et al. Higher dietary fructose is associated with impaired hepatic adenosine triphosphate homeostasis in obese individuals with type 2 diabetes // Hepatology. – 2012. – Vol. 56. – P.952-960.

Angelopoulos T.J., Lowndes J., Sinnett S., Rippe J.M. Fructose containing sugars do not raise blood pressure or uric acid at normal levels of human consumption // J Clin Hypertens (Greenwich). – 2015. – Vol. 17, N 2. – P. 87-94. doi: 10.1111/jch.12457.

Blau L.W. Cherry diet control for gout and arthritis // Tex Rep Biol Med. – 1950. – Vol. 8. – P. 309-311.

Brule D., Sarwar G., Savoie L. Changes in serum and urinary uric acid levels in normal human subjects fed purinerich foods containing different amounts of adenine and hypoxanthine // J Am Coll Nutr. – 1992. – Vol. 11. – P. 353-8.

Choi H.K., Atkinson K., Karlson E., et al. Purine-rich foods, dairy and protein intake, and the risk of gout in men // Engl J Med. – 2004. – Vol. 350. – P. 1093-1103.

Choi H.K., Atkinson K., Karlson E., et al. Beer, liquor, and wine consumption and serum uric acid level: the Third National Health and Nutrition Examination Survey // Arthritis Rheum. – 2004. – Vol. 51, N 6. – P. 1023-1029.

Choi H.K., Atkinson K., Karlson E.W., et al. Alcohol intake and risk of incident gout in men: a prospective study // Lancet. – 2004. – Vol. 363. – P. 1277-81.

Choi H.K., Atkinson K., Karlson E.W., Curhan G. Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals followup study // Arch Intern Med. – 2005. – Vol. 165, N 7. – P. 742-748.

Choi H.K., Atkinson K., Karlson E.W., et al. Pathogenesis of Gout // Ann Intern Med. – 2005. – Vol. 143. – P. 499–516.

Choi H.K., Liu S., Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey // Arthritis Rheum. – 2005. – Vol. 52, N 1. – P. 283-289.

Choi H.K., Curhan G. Coffee, tea, and caffeine consumption and serum uric acid level: the Third National Health and Nutrition Examination Survey // Arthritis Rheum. – 2007. – Vol. 57, N 5. – P. 816-82.

Choi J.W., Ford E.S., Gao X., Choi H.K. Sugars sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey // Arthritis Rheum. – 2008. – Vol. 59, N 1. – P. 109-116.

Choi H.K., Curhan G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study // BMJ. – 2008. – Vol. 336, N 7639. – P. 309-312.

Choi H.K., Gao X., Curhan G. Vitamin C intake and the risk of gout in men: a prospective study // Arch Intern Med. – 2009. – Vol. 169, N 5. – P. 502-507.

Choi H.K., Willett W., Curhan G. Fructose rich beverages and risk of gout in women // JAMA. – 2010. – Vol. 304, N 20. – P. 2270-2278.

Choi H.K., Curhan G. Coffee consumption and risk of incident gout in women: the Nurses’ Health Study // Am J Clin Nutr. – 2010. – Vol. 92, N 4. – P. 922-7.

Costa-Bauza A., Grases F., Calvó P., et al. Effect of Consumption of Cocoa-Derived Products on Uric Acid Crystallization in Urine of Healthy Volunteers // Nutrients. – 2018. – Vol. 10, N 10. – P. 1516.

Dalbeth N., Wong S., Gamble G.D., et al. Acute effect of milk on serum urate concentrations: a randomised controlled crossover trial // Ann Rheum Dis. – 2010. – Vol. 68. – P. 1677-1682.

Dalbeth N., Ames R., Gamble G.D., et al. Effects of skim milk powder enriched with glycomacropeptide and G600 milk fat extract on frequency of gout flares: a proof-of-concept randomised controlled trial // Ann Rheum Dis. – 2012. – Vol. 71. – P. 929-934.

Dessein P., Shipton E., Stanwix A., et al. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study // Ann Rheum Dis. – 2000. – Vol. 59, N 7. – P. 539-543.

Drum D.E., Goldman P.A., Jankowski C.B. Elevation of serum uric acid as a clue to alcohol abuse // Arch Intern Med. – 1981. – Vol. 141. – P. 477-9.

Du H., Li L., Bennett D., et al. Fresh fruit consumption and major cardiovascular disease in China // N Engl J Med. – 2016. – Vol. 374, N 14. – P. 1332-43.

Ebstein W. The Nature and Treatment of Gout // London: Bailliere, Tindall, & Cox.– 1889. – P. 456.

Faller J., Fox I.H. Ethanol-induced hyperuricemia: evidence for increased urate production by activation of adenine nucleotide turnover // N Engl J Med. – 1982. – Vol. 307. – P. 1598-602.

Gao X., Curhan G., Forman J.P, et al. Vitamin C intake and serum uric acid concentration in men // J Rheumatol. – 2008. – Vol. 35 (9). – P. 1853-1858.

Garrel D.R., Verdy M., PetitClerc C., et al. Milk– and soy-protein ingestion: acute effect on serum uric acid concentration // Am J Clin Nutr. – 1991. – Vol. 53. – P. 665-9.

Garrod A.B. A treatise on gout and rheumatic gout (rheumatoid arthritis) // London: Longmans, Green. – 1876.

Grases F., Rodriguez A., Costa-Bauza A. Theobromine inhibits uric acid crystallization. A potential application in the treatment of uric acid nephrolithiasis // PLoS One. – 2014. – Vol. 9, N 10. – P. 111184.

Green H., Fraser I.G. Differential effects of exercise intensity on serum uric acid concentration // Med Sci Sports Exerc. – 1988. – Vol. 20. – P. 55-59.

Grygiel-Górniak B., Mosor M., Marcinkowska J., et al. Uric acid and obesityrelated phenotypes in postmenopausal women // Mol Cell Biochem. – 2018. – Vol. 443, N 1. – P. 111–119.

Guasch-Ferré M., Bulló M., Babio N., et al. Mediterranean diet and risk of hyperuricemia in elderly participants at high cardiovascular risk // J Gerontol A Biol Sci Med Sci. – 2013. – Vol. 68. – P. 1263-1270.

Halla J.T., Ball G.V. Saturnine gout: a review of 42 patients // Semin Arthritis Rheum. – 1982. – Vol. 11. – P. 307-14.

Hara S., Tsuji H., Ohmoto Y., et al. High serum uric acid level and low urine pH as predictors of metabolic syndrome: a retrospective cohort study in a Japanese urban population // Metabolism. – 2012. – Vol. 61, N 2. – P. 281-288.

Huang H.Y., Appel L.J., Choi M.J., et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial // Arthritis Rheum. – 2005. – Vol. 52. – P. 1843-1847.

Huang L., Huang C., Chen M., Mao I. Effects of profuse sweating induced by exercise on urinary uric acid excretion in a hot environment // Chin J Physiol. – 2010. – Vol. 53, N 4. – P. 254-261.

Consumption of cherries lowers plasma urate in healthy women / R.A. Jacob, G.M. Spinozzi, V.A. Simon, [et al.] // J Nutr. – 2003. – Vol. 133, N 6. – P. 1826-1829.

Jacob R.A., Spinozzi G.M., Simon V.A., et al. Hypothesis: could excessive fructose intake and uric acid cause type 2 diabetes? // Endocr Rev. – 2009. – Vol. 30, N 1. – P. 96-116.

Juraschek S.P., Miller E.R., Gelber A.C. Effect of Oral Vitamin C Supplementation on Serum Uric Acid: A Metaanalysis of Randomized Controlled Trials // Arthritis Care Res (Hoboken). – 2011. – Vol. 63, N 9. – P. 1295–1306.

Indyk H.E., Woollard D.C. Determination of orotic acid, uric acid, and creatinine in milk by liquid chromatography // JAOAC Int. – 2004. – Vol. 87, N 1. – P. 116-22.

Kanbara A., Hakoda M., Seyama I. Urine alkalization facilitates uric acid excretion // Nutr J. – 2010. – Vol. 9. – P. 45.

Kaya M., Moriwaki Y., Ka T., et al. Plasma concentrations and urinary excretion of purine bases (uric acid, hypoxanthine, and xanthine) and oxypurinol after rigorous exercise // Metabolism. – 2006. – Vol. 55, N 1. – P. 103-107.

Keith R.M., Katie MC. Consumption of 100% Tart Cherry Juice Reduces Serum Urate in Overweight and Obese Adults // Curr Dev Nutr. – 2019. – Vol. 3, N 5. – P. 11.

Kelley D.S., Rasooly R., Jacob RA., et al. Consumption of Bing sweet cherries lowers circulating concentrations of inflammation markers in healthy men and women // J Nutr. – 2006. – Vol. 136, N 4. – P. 981-6.

Kiyohara C., Kono S., Honjo S., et al. Inverse association between coffee drinking and serum uric acid concentrations in middle-aged Japanese males // Br J Nutr. – 1999. – Vol. 82. – P. 125-130.

Kontogianni M.D., Chrysohoou C., Panagiotakos D.B., et al. Adherence to the Mediterranean diet and serum uric acid: the ATTICA study. // Scand J Rheumatol. – 2012. – Vol. 41, N 6. – P. 442-449.

Kurajoh M., Ka T., Okuda C., et al. Effects of bovine milk ingestion on urinary excretion of uric acid // Int J Clin Pharmacol Ther. – 2011. – Vol. 49, N 6. – P. 366-370.

Le M.T., Frye R.F., Rivard C.J., et al. Effects of high-fructose corn syrup and sucrose on the pharmacokinetics of fructose and acute metabolic and hemodynamic responses in healthy subjects // Metabolism. – 2012. – Vol. 61, N 5. – P. 641-651.

Lecoultre V., Egli L., Theytaz F., et al. Fructose-induced hyperuricemia is associated with a decreased renal uric acid excretion in humans // Diabetes Care. – 2013. – Vol. 36, N 9. – P. 149-159.

Leyva F., Wingrove C.S., Godsland I.F., et al. The glycolytic pathway to coronary heart disease: a hypothesis // Metabolism. – 1998. – Vol. 47. – P. 657-662.

Lyu L.C., Hsu C.Y., Yeh C.Y., et al. A case-control study of the association of diet and obesity with gout in Taiwan // Am J Clin Nutr. – 2003. – Vol. 78, N 4. – P. 690-701.

Martin K.R., Bopp J., Burrell L., Hook G. The effect of 100% tart cherry juice on serum uric acid levels, biomarkers of inflammation and cardiovascular disease risk factors // FASEB J. – 2011. – Vol. 25. – P. 3392.

Meneses-Leon J., Denova-Gutiérrez E., Castañón-Robles S., et al. Sweetened beverage consumption and the risk of hyperuricemia in Mexican adults: a cross-sectional study // BMC Public Health. – 2014. – Vol. 14. – P. 445.

Messina M., Messina V.L., Chan P. Soyfoods, hyperuricemia and gout: a review of the epidemiologic and clinical data. // Asia Pac J Clin Nutr. – 2011. – Vol. 20, N 3. – P. 347-358.

Moriwaki Y., Ka T., Takahashi S., et al. Effect of beer ingestion on the plasma concentrations and urinary excretion of purine bases: one-month study // Nucleosides Nucleotides Nucleic Acids. – 2006. – Vol. 25, N 9–11. – P. 1083-1085.

Mubarak A., Hodgson J.M., Considine M.J., et al. Supplementation of a high-fat diet with chlorogenic acid is associated with insulin resistance and hepatic lipid accumulation in mice // J Agric Food Chem. – 2013. – Vol. 61, N 18. – P. 4371-4378.

Nakamura K., Sakurai M., Miura K., et al. Alcohol intake and the risk of hyperuricaemia: a 6-year prospective study in Japanese men. // Nutr Metab Cardiovasc Dis. – 2012. – Vol. 22, N 11. – P. 989-96.

Neogi T., Chen C., Chaisson C., et al. Drinking water can reduce the risk of recurrent gout attacks // Paper presented at: ACR Annual Scientific Meeting; October 16–21. – 2009. – Philadelphia.

Neogi T., Chen C., Niu J., et al. Alcohol quantity and type on risk of recurrent gout attacks: an internetbased casecrossover study // Am J Med. – 2014. – Vol. 127, N 4. – P. 311-318.

Nishimura T., Shimizu T., Mineo I., et al. Influence of daily drinking habits on ethanol-induced hyperuricemia // Metabolism. – 1994. – Vol. 43. – P. 745-748.

Nuki G., Simkin P.A. A concise history of gout and hyperuricemia and their treatment // Arthritis Res Ther. – 2006. – Vol. 8, N 1. – P. 1.

Puig J.G., Fox I.H. Ethanol-induced activation of adenine nucleotide turnover. Evidence for a role of acetate // J Clin Invest. – 1984. – Vol. 74, N 3. – P. 936-941.

Reungjui S., Roncal C.A., Sato W., et al. Hypokalemic nephropathy is associated with impaired angiogenesis // J Am Soc Nephrol. – 2008. – Vol. 19, N 1. – P. 125-34.

Rho Y.H., Zhu Y., Choi H.K. The epidemiology of uric acid and fructose // Semin Nephrol. – 2001. – Vol. 31, N 5. – P. 410-419.

Richette P., Bardin T. Gout. // Lancet. – 2010. – Vol. 375, N 9711. – P. 318–28.

Sanchez-Lozada L.G., Lanaspa M.A., Cristobal-Garcia M., et al. Uric acidinduced endothelial dysfunction is associated with mitochondrial alterations and decreased intracellular ATP concentrations // Nephron Exp Nephrol. – 2012. – Vol. 121, N 3–4. – P. 71-8.

Schlesinger N., Rabinowitz R., Schlesinger M. Pilot studies of cherry juice concentrate for gout flare prophylaxis // J Arthritis. – 2012. – Vol. 1. – P. 1-5.

Schäufele T.G., Schlaich M.P., Delles C., et al. Impaired basal NO activity in patients with glomerular disease and the influence of oxidative stress // Kidney Int. – 2006. – Vol. 70. – P. 1177-1181.

Simmonds H.A., Webster D.R., Becroft D.M., Potter C.F. Purine and pyrimidine metabolism in hereditary orotic aciduria: some unexpected effects of allopurinol // Eur J Clin Invest. – 1980. – Vol. 10, N 4. – P. 333-339.

Snaith M. Gout and alcohol // Rheumatology. – 2004. – Vol. 43, N 10. – P. 1208–1209.

Stamostergiou J., Theodoridis X., Ganochoriti V., et al. The role of the Mediterranean diet in hyperuricemia and gout // Mediterr J Rheumatol. – 2018. – Vol. 29, N 1. – P. 21-51.

Stamp L.K., O’Donnell J.L., Frampton C., et al. Clinically insignificant effect of supplemental vitamin C on serum urate in patients with gout; a pilot randomised controlled trial // Arthritis Rheum. – 2013. – Vol. 65, N 6. – P. 1636-1642.

Sun S.Z., Flickinger B.D., Patricia S., et al. Lack of association between dietary fructose and hyperuricemia risk in adults // Nutr Metab (Lond). – 2010. – Vol. 7. – P. 16.

Tanabe K., Tamura Y., Lanaspa M.A., et al. Epicatechin limits renal injury by mitochondrial protection in cisplatin nephropathy // Am J Physiol Renal Physiol. – 2012. – Vol. 303, N 9. – P. 1264-74.

Villegas R., Xiang Y.B., Elasy T., et al. Purine-rich foods, protein intake, and the prevalence of hyperuricemia: the Shanghai Men’s Health Study // Nutr Metab Cardiovasc Dis. – 2012. – Vol. 22. – P. 409-416.

Wang H., Nair M.G., Strasburg G.M., et al. Antioxidant polyphenols from tart cherries (Prunus cerasus) // J Agric Food Chem. – 1999. – Vol. 47, N 3. – P. 840-4.

Wang D.D., Sievenpiper J.L., de Souza R.J., et al. The effects of fructose intake on serum uric acid vary among controlled dietary trials // J Nutr. – 2012. – Vol. 142, N 5. – P. 916-923.

Williams R.J., Spencer J.P., Rice-Evans C. Flavonoids: antioxidants or signalling molecules? // Free Radic Biol Med. – 2004. – Vol. 36, N 7. – P. 838-49.

Williams P.T. Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men // Am J Clin Nutr. – 2008. – Vol. 87, N 5. – P. 1480-7.

Yamamoto T., Moriwaki Y., Ka T., et al. Effect of sauna bathing and beer ingestion on plasma concentrations of purine bases // Metabolism. – 2004. – Vol. 53, N 6. – P. 772-776.

Yamamoto T., Moriwaki Y., Ka T., et al. Effect of purine-free low-malt liquor (happo-shu) on the plasma concentrations and urinary excretion of purine bases and uridine – comparison between purine-free and regular happo-shu // Horm Metab Res. – 2004. – Vol. 36, N 4. – P. 231-237.

Yamamoto T., Moriwaki Y., Takahashi S. Effect of ethanol on metabolism of purine bases (hypoxanthine, xanthine, and uric acid) // Clin Chim Acta. – 2005. – Vol. 356, N 1-2. – P. 35-57.

Yamanaka H., Kawagoe Y., Taniguchi A., et al. Accelerated purine nucleotide degradation by anaerobic but not by aerobic ergometer muscle exercise. // Metabolism. – 1992. – Vol. 41, N 4. – P. 364-369.

Zgaga L., Theodoratou E., Kyle J., et al. The association of dietary intake of purine-rich vegetables, sugar-sweetened beverages and dairy with plasma urate, in a crosssectional study // The PLoS One. – 2012. – Vol. 7. – P. 38123.

Zhang Y., Neogi T., Chen C., et al. Cherry consumption and decreased risk of recurrent gout attacks // Arthritis Rheum. – 2012. – Vol. 64, N 12. – P. 4004-4011.

Zöllner N. Influence of various purines on uric acid metabolism // Bibl Nutr Dieta. – 1973. – Vol. 19. – P. 34-43.