From Multidimensional Management to Mechanistic Insight: A Review of Interventions for Hyperuricemia

As a major metabolic abnormality following hyperglycemia, hypertension, and hyperlipidemia, hyperuricemia has emerged as a significant global public health issue. The pathological mechanisms of hyperuricemia are complex; it not only directly triggers gout but is also closely associated with various chronic diseases, such as cardiovascular disease, diabetes, and chronic kidney disease, posing a systemic threat to individual health. This article systematically reviews the epidemiological characteristics, pathophysiological mechanisms, clinical consequences, and related risk factors of hyperuricemia, and especially focuses on the research advances and mechanisms of comprehensive intervention strategies, including diet, exercise, pharmacotherapy, and lifestyle modifications. Dietary interventions primarily function by regulating the activity of enzymes and transporters related to uric acid metabolism, ameliorating gut microbiota dysbiosis, and alleviating inflammatory responses. Exercise interventions synergistically improve uric acid homeostasis through multiple mechanisms, including the regulation of purine metabolic enzyme activity and the improvements of body composition, insulin resistance, and oxidative stress. Pharmacotherapy, serving as a core measure for patients with moderate-to-severe conditions, directly lowers serum uric acid levels by inhibiting uric acid production or promoting excretion. Although various intervention modalities exhibit distinct effects in regulating uric acid production, promoting excretion, and improving the metabolic-inflammatory environment, challenges such as significant heterogeneity in individual response and uncertainty regarding long-term efficacy remain prevalent. Furthermore, given the increasing trend toward a younger onset of hyperuricemia, prevention and control strategies targeting children and adolescents require urgent reinforcement. Future efforts should focus on conducting multi-center, large-sample clinical studies with clear mechanisms and establishing individualized health management plans based on population characteristics, thereby promoting the precise prevention and treatment of hyperuricemia.