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Effect of diet, body mass index, and proton pump inhibitors on antitubercular therapy–induced hyperuricemia in patients of tuberculosis

Meenu Pichholiya, Arvind Kumar Yadav, Nitin Kothari, Jameela Tahashildar, Gaurav Chhabra, Atul Luhadia.

Abstract
Background: Risk factors for developing hyperuricemia other than inherited abnormalities are obesity, moderate to heavy alcohol intake, high blood pressure, and abnormal kidney function. Factors that increase urate formation are excess dietary purine intake, increased nucleic acid turnover, obesity, and exercise. Factors that decrease urate excretion are kidney disease, diabetic ketoacidosis, hypertension, drugs, and trisomy 21.

Aims and Objectives: To see the effect of diet, body mass index (BMI), and proton pump inhibitors (PPIs) in antitubercular therapy (ATT)–induced hyperuricemic tubercular patients.

Materials and Methods: This prospective study was conducted at a tertiary care teaching hospital of Rajasthan in tubercular patients aged 18–65 years of either sex. Serum uric acid level was estimated at weekly interval after starting ATT for 2 months along with baseline value. Patients developing hyperuricemia were finally included in the study. Patients were divided into vegetarian and nonvegetarian groups. BMI of all the patients was calculated. All the patients were grouped into two categories on the basis of those receiving or not receiving PPI. Appropriate statistical tests were used to compare the data.

Results: Out of the total 123 hyperuricemic patients, 71 patients were on vegetarian diet while 52 patients were on nonvegetarian diet. Difference between the serum uric acid levels of vegetarian and nonvegetarian groups was found to be insignificant. Out of the total, 90 patients were underweight, 28 were having normal weight while 5 were overweight. Pearson’s correlation test showed no correlation between BMI and serum uric acid levels. PPIs were taken by 72 patients. Difference between serum uric acid levels of patients receiving PPIs and those not receiving PPIs was found to be insignificant.

Conclusion: The serum uric acid level was not found to be affected by diet, BMI, and use of PPI in ATT-treated tubercular patients probably due to some altered physiology in these patients.

Key words: Diet; Body Mass Index; Proton Pump Inhibitors; Antitubercular Therapy; Hyperuricemia



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