Uric acid concentration is higher than the normal value, which is mainly caused by the increase of uric acid production and the decrease of uric acid excretion, and sometimes the two coexist.
Increased uric acid production: mainly including high purine diet intake and increased endogenous purine metabolism. Uric acid production caused by food is proportional to purine content in food. Purine-rich foods mainly include animal liver, kidney and anchovies. The increase of endogenous purine metabolism in the body is mainly related to the synthesis and decomposition of purine.
Decreased uric acid excretion: about 2/3 of uric acid is excreted through the kidney, and the rest 1/3 is excreted through extrarenal channels such as intestine and biliary tract. About 90% patients with persistent hyperuricemia have the defect of kidney processing uric acid, which is manifested as decreased uric acid excretion, including decreased glomerular filtration rate, increased renal tubular reabsorption, decreased renal tubular secretion and urate crystal deposition.
Uric acid concentration is lower than normal, which is mainly caused by various reasons, such as renal tubular reabsorption of uric acid, massive loss of urine, and serious damage to liver function and decreased uric acid production. Such as acute hepatic necrosis and hepatolenticular degeneration. In addition, chronic cadmium poisoning, the use of sulfonamides and high-dose glucocorticoids, xanthine oxidase involved in uric acid production, and congenital defects of purine nucleotidase can also cause the decrease of serum uric acid.
Therefore, with normal uric acid, the serum uric acid concentration of adults with enzymatic method is 150~4 16μmol/L for men and 89~357μmol/L for women. The high or low uric acid concentration is abnormal, which needs to be paid attention to, and the causes should be identified and actively treated.