Nevarnosti povišane sečne kisline

Prvotno je putika veljala za glavno motnjo povezano z visokim nivojem sečne kisline, dandanes vemo, da je visok nivo sečne kisline povezan z mnogo hujšimi in usodnimi stanji, vključno z metaboličnim sindromom, diabetesom tipa II, odpovedjo ledvic in srčno-žilnimi boleznimi. V letih 2016-2017 je skupina študij pokazala, da ima povišan nivo sečne kisline vlogo tudi pri bipolarni motnji. Mnogi ne vedo, da je možno imeti povišano sečno kislino in ne nujno tudi putike.              

                                       

Sečna kislina, stranski produkt normalne celične rasti in presnove, se v krvi povišuje, ko se staramo (zaradi slabšega delovanje ledvic), kar pa še poslabša neustrezna prehrana, značilna za zahodni svet ter alkoholne pijače. Rdeče meso in sladkorji, še posebno fruktoza, lahko močno povečajo proizvodnjo sečne kisline. Putika ni edina bolezen povezana s povišano koncentracijo sečne kisline. Spodnja tabela prikazuje zvišanje tveganja za posamezno bolezensko stanje v povezavi z visokim nivojem sečne kisline v krvi.

Zvišanje tveganja povezano z visokim nivojem sečne kisline v krvi

Stanje

Zvišanje tveganja zaradi visoke koncentracije sečne kisline v krvi

Odpoved ledvic

7 % za 1mg/dl povišanja sečne kisline

Kronično vnetje (izmerjeno s hs - CRP)

52 %

Metabolični sindrom

410 %

Diabetes

18 % za 1mg/dl povišanja sečne kisline

Nestabilni lipidno bogati arterijski plaki

143 %

Prehipertenzija

44 %

Atrijska fibrilacija (srčna aritmija)

67 %

Povečanje srčne mišice

96 % glede na najvišji in najnižji nivo sečne kisline

26 % povišanje za 1 mg/dl povišanja sečne kisline

Bolnišnične smrti zaradi srčnega infarkta

432 %

Večji srčni zaplet (smrt, kongestivno srčno popuščanje, ponavljajoči srčni infarkti, kap)

184 %

 

Nedavne znanstvene in klinične študije so pokazale, da naravni izvleček, bogat s tanini, pridobljen iz užitnega sadja drevesa Terminalia Bellerica, iz južno-vzhodne Azije (ki se že dolgo uporablja v tradicionalni indijski medicini) pomaga ohranjati raven sečne kisline v normalnem območju. Ta standardizirani izvleček zavira encim ksantin-oksidazo; kritični encim v metabolizmu sečne kisline ter inducibilno dušikovo oksid sintazo.

V klinični študiji s placebo kontrolnimi skupinami se je testirancem z zvišanimi vrednostmi sečne kisline po 24-ih tednih jemanja, 2-krat dnevno po 500 mg izvlečka T. bellerica znižal nivo sečne kisline v povprečju za 27,59 %. Z uživanjem izvlečka T. bellericaje je ciljno koncentracijo sečne kisline v serumu (≤ 6 mg/dL) doseglo 88,8 % testirancev. Poudariti je potrebno, da jemanje izvlečka T. bellerica pri nobenem od testirancev ni povzročilo stranskih učinkov, le ti pa so se pojavili pri izbranem testiranem zdravilu.

Te ugotovitve kažejo na še eno možno naravno pot v boju s tveganji mnogih s starostjo povezanih motenj.

 

Reference

  1. Jin M, Yang F, Yang I, et al. Uric acid, hyperuricemia and vascular diseases. Front Biosci (Landmark Ed).2012;17:656-69.
  2. Ford ES, Li C, Cook S, et al. Serum concentrations of uric acid and the metabolic syndrome among US children and adolescents. Circulation. 2007;115(19):2526-32.
  3. Lehto S, Niskanen L, Ronnemaa T, et al. Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke. 1998;29(3):635-9.
  4. Schretlen DJ, Inscore AB, Vannorsdall TD, et al. Serum uric acid and brain ischemia in normal elderly adults. Neurology. 2007;69(14):1418-23.
  5. Siu YP, Leung KT, Tong MK, et al. Use of allopurinol in slowing the progression of renal disease through its ability to lower serum uric acid level. Am J Kidney Dis. 2006;47(1):51-9.
  6. Bartoli F, Crocamo C, Dakanalis A, et al. Purinergic system dysfunctions in subjects with bipolar disorder: A comparative cross-sectional study. Compr Psychiatry. 2017;73:1-6.
  7. Bartoli F, Crocamo C, Gennaro GM, et al. Exploring the association between bipolar disorder and uric acid: A mediation analysis. J Psychosom Res. 2016;84:56-9.
  8. Bartoli F, Crocamo C, Mazza MG, et al. Uric acid levels in subjects with bipolar disorder: A comparative meta-analysis. J Psychiatr Res. 2016;81:133-9.
  9. Machado-Vieira R, Salem H, Frey BN, et al. Convergent lines of evidence support the role of uric acid levels as a potential biomarker in bipolar disorder. Expert Rev Mol Diagn. 2017;17(2): 107-8.
  10. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011;63(10):3136-41.
  11. Usharani P, Nutalapati C, Pokuri VK, et al. A randomized, double-blind, placebo-, and positive-controlled clinical pilot study to evaluate the efficacy and tolerability of standardized aqueous extracts of Terminalia chebula and Terminalia bellerica in subjects with hyperuricemia. Clin Pharmacol. 2016;8:51-9.
  12. Latha RC, Daisy P. Insulin-secretagogue, antihyperlipidemic and other protective effects of gallic acid isolated from Terminalia bellerica Roxb. in streptozotocin-induced diabetic rats. Chem Biol Interact.2011;189(1-2):112-8.
  13. Hazra B, Sarkar R, Biswas S, et al. Comparative study of the antioxidant and reactive oxygen species scavenging properties in the extracts of the fruits of Terminalia chebula, Terminalia belerica and Emblica officinalis. BMC Complement Altern Med. 2010;10:20.
  14. Love BL, Barrons R, Veverka A, et al. Urate-lowering therapy for gout: focus on febuxostat. Pharmacotherapy. 2010;30(6):594-608.
  15. Lupton GP, Odom RB. The allopurinol hypersensitivity syndrome. J Am Acad Dermatol. 1979;1(4):365-74.
  16. Vitart V, Rudan I, Hayward C, et al. SLC2A9 is a newly identified urate transporter influencing serum urate concentration, urate excretion and gout. Nat Genet. 2008;40(4):437-42.
  17. Angelopoulos TJ, Lowndes J, Zukley L, et al. The effect of high-fructose corn syrup consumption on triglycerides and uric acid. J Nutr. 2009;139(6):1242S-5S.
  18. Cirillo P, Sato W, Reungjui S, et al. Uric acid, the metabolic syndrome, and renal disease. J Am Soc Nephrol.2006;17(12 Suppl 3):S165-8.
  19. Giuffra V, Minozzi S, Vitiello A, et al. On the history of gout: paleopathological evidence from the Medici family of Florence. Clin Exp Rheumatol. 2017;35(2):321-6.
  20. Schlesinger N, Norquist JM, Watson DJ. Serum urate during acute gout. J Rheumatol. 2009;36(6):1287-9.
  21. Sun SZ, Flickinger BD, Williamson-Hughes PS, et al. Lack of association between dietary fructose and hyperuricemia risk in adults. Nutr Metab (Lond). 2010;7:16.
  22. Tsai CW, Lin SY, Kuo CC, et al. Serum Uric Acid and Progression of Kidney Disease: A Longitudinal Analysis and Mini-Review. PLoS One. 2017;12(1):e0170393.
  23. Raeisi A, Ostovar A, Vahdat K, et al. Association of serum uric acid with high-sensitivity C-reactive protein in postmenopausal women. Climacteric. 2017;20(1):44-8.
  24. Choi H, Kim HC, Song BM, et al. Serum uric acid concentration and metabolic syndrome among elderly Koreans: The Korean Urban Rural Elderly (KURE) study. Arch Gerontol Geriatr. 2016;64:51-8.
  25. Rubio-Guerra AF, Morales-Lopez H, Garro-Almendaro AK, et al. Circulating Levels of Uric Acid and Risk for Metabolic Syndrome. Curr Diabetes Rev. 2017;13(1):87-90.
  26. Juraschek SP, McAdams-Demarco M, Miller ER, et al. Temporal relationship between uric acid concentration and risk of diabetes in a community-based study population. Am J Epidemiol. 2014;179(6):684-91.
  27. Moleda P, Fronczyk A, Safranow K, et al. Is Uric Acid a Missing Link between Previous Gestational Diabetes Mellitus and the Development of Type 2 Diabetes at a Later Time of Life? PLoS One. 2016;11(5):e0154921.
  28. Sun HL, Pei D, Lue KH, et al. Uric Acid Levels Can Predict Metabolic Syndrome and Hypertension in Adolescents: A 10-Year Longitudinal Study. PLoS One. 2015;10(11):e0143786.
  29. Clarson LE, Hider SL, Belcher J, et al. Increased risk of vascular disease associated with gout: a retrospective, matched cohort study in the UK clinical practice research datalink. Ann Rheum Dis.2015;74(4):642-7.
  30. Singh JA. When gout goes to the heart: does gout equal a cardiovascular disease risk factor? Ann Rheum Dis. 2015;74(4):631-4.
  31. Cuspidi C, Facchetti R, Bombelli M, et al. Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population. Am J Hypertens. 2017.
  32. Gazi E, Temiz A, Altun B, et al. The association between serum uric acid level and heart failure and mortality in the early period of ST-elevation acute myocardial infarction. Turk Kardiyol Dern Ars. 2014;42(6):501-8.
  33. Kawabe M, Sato A, Hoshi T, et al. Gender differences in the association between serum uric acid and prognosis in patients with acute coronary syndrome. J Cardiol. 2016;67(2):170-6.
  34. Lotufo PA, Baena CP, Santos IS, et al. Serum Uric Acid and Prehypertension Among Adults Free of Cardiovascular Diseases and Diabetes: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Angiology. 2016;67(2):180-6.
  35. Tamariz L, Hernandez F, Bush A, et al. Association between serum uric acid and atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm. 2014;11(7):1102-8.
  36. Ando K, Takahashi H, Watanabe T, et al. Impact of Serum Uric Acid Levels on Coronary Plaque Stability Evaluated Using Integrated Backscatter Intravascular Ultrasound in Patients with Coronary Artery Disease. J Atheroscler Thromb. 2016;23(8):932-9.
  37. Tao R, Li H. High serum uric acid level in adolescent depressive patients. J Affect Disord. 2015;174:464-6.