Page 77 - EJMO-9-2

Eurasian Journal of
Medicine and Oncology Gut microbiota and hyperuricemia: Mechanisms and therapeutic strategies

gut microbiota and gut barrier function, which is essential significant association between hyperhomocysteinemia
for overall health and well-being (Table 3). and HUA. 112
The human gut harbors certain bacteria capable of Vitamin C has been demonstrated to have antioxidant and
synthesizing Vitamin B12, highlighting the gut microbiota anti-inflammatory properties. A logistic regression analysis
as a potential source of Vitamin B. Prospective cohort revealed an inverse relationship between Vitamin C intake
studies have demonstrated that the intake and serum and the risk of HUA in both men and women. However,
concentrations of folic acid, Vitamin B6, and Vitamin B12 a meta-analysis demonstrated no significant difference
are inversely associated with the risk of metabolic syndrome in effect between high and low doses of Vitamin C
in young individuals of both black and white ethnicities in supplementation. Further clinical trials with longer
the United States. Using multivariate logistic regression supplementation periods and varying doses are warranted
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analysis, studies have reported that increasing folic acid to determine the optimal dosage for preventing HUA. 113-117
and Vitamin B12 intake may reduce the risk of HUA in In addition, high-dose Vitamin D supplementation
men. Folic acid, also known as Vitamin B9, is a potent has been found to modify the intestinal microbiome
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competitive inhibitor of XO, an enzyme involved in composition. In pre-adolescent females, 9 weeks of
UA metabolism. Comparisons have demonstrated that supplementation with 50,000 IU of cholecalciferol per
folic acid and its coenzyme derivative, tetrahydrofolate, week resulted in a decrease in Bacteroides and Lactobacillus
are approximately twice as effective as allopurinol, a abundance and an increase in Firmicutes and Bifidobacteria.
commonly used urate-lowering medication, in inhibiting The relationship between Vitamin D and UA levels is
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XO activity. The Chinese Primary Prevention Trial of complex and bidirectional. Vitamin D deficiency is
Stroke (CSPPT) indicated that compared with enalapril approximately 1.5 times more common in individuals with
alone, enalapril-folic acid therapy significantly reduced HUA compared to those with normal Vitamin D levels.
SUA concentration in hypertensive adults. The urate- According to the National Wellbeing and Nourishment
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lowering effects of folic acid may be attributed to its Examination Study, serum 25-hydroxyvitamin D levels
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ability to reduce homocysteine levels. In a retrospective may be negatively correlated with HUA in the general
cross-sectional analysis, serum homocysteine levels American adult population. A two-sample bidirectional
were positively correlated with SUA levels, displaying a Mendelian randomization investigation demonstrated

Table 3. The role of vitamins in diets

Type Attribution Function Mechanisms affecting hyperuricemia
Vitamin B (B6/ Water-soluble Improves immunity, maintains the Inhibiting uric acid biosynthesis and
B12/folic acid) vitamins nervous system, and is a cofactor used by stimulating uric acid excretion by regulating
hundreds of enzymes that perform energy gut microbiota; folic acid can reduce
metabolism, DNA, and protein synthesis; homocysteine and reduce the catabolism of
folic acid is involved in purine and thymine purine nucleotides
synthesis, as well as in the synthesis of heme
Vitamin C Water-soluble It can eliminate free radicals and ascorbic Improves renal function; increases
vitamin acid (donor electrons in various enzymatic glomerular filtration rate; reduces serum
and non-enzyme catalysis) in the body; urate concentration; competitively inhibits
it is a powerful antioxidant; preventing the reabsorption of serum urate
arteriosclerosis can promote intestinal
absorption of iron and prevent anemia;
participates in collagen synthesis
Vitamin D Fat-soluble Maintain serum calcium and phosphorus It can affect uric acid transport in the
vitamins levels, and resist rickets; activating Vitamin proximal tubule of the kidney by affecting
D has potential renal protective effects, the parathyroid hormone and reducing
which can slow down the progression uric acid salt excretion; improves intestinal
of chronic kidney disease and reduce permeability and restores tight intestinal
inflammatory biomarkers; low doses of connections to protect intestinal epithelial
active Vitamin D analogs can prevent aortic barrier function, thereby reducing
calcification and lower blood pressure inflammation
Vitamin E Fat-soluble Enhance anticoagulant and vasodilator Interferes with bacterial biofilm and prevents
vitamins effects, and promote plasma membrane the formation of biofilm in vitro, preventing
repair; as a free radical scavenger molecule, oxidative stress; inhibition of xanthine
it can inhibit lipid peroxidation oxidase to reduce uric acid production

Volume 9 Issue 2 (2025) 69 doi: 10.36922/ejmo.8579