Hyperuricemia and gout as metabolic disorders, and purine nucleotide and uric acid metabolism.

摘要

Hyperuricaemia and gout are included among such lifestyle-related diseases as obesity, diabetes, hypertension and dyslipidaemia. Hyperuricaemia involves the serum urate level exceeding the solubility limit, the resulting crystallized urate deposits causing gouty arthritis and a renal disorder induced by gout. Uric acid is an endproduct of purine nucleotide degradation. This review summarizes recent biochemical and molecular biological data from principally Japanese studies on purine nucleotide biosynthesis, uric acid formation and its renal excretion. The Japanese Society of Gout and Nucleic Acid Metabolism published in 2001 contains guidelines for the management of hyperuricaemia and gut in order to standardize the diagnosis and therapy of these disorders. These guidelines define hyperuricaemia as a urate concentration of over seven mg/dl in the blood indicating that the solubility limit based on the physicochemical properties of urate. The required change in the patient's lifestyle, including dietary habits, is also reviewed.