西红柿

又称番茄、洋柿子，相信大家都非常熟悉，丰富的营养和酸酸甜甜的口感使它获得许多人的喜爱。另一方面，西红柿是一种低嘌呤食物，因此，不少痛风患者为了控制尿酸水平，也可能喜欢选择西红柿作为餐桌上的常客。然而国外有研究发现，吃西红柿竟可能是痛风发作的诱因之一！ 2015年，Flynn TJ等在《BMC Musculoskelet Disord》发表的一篇文章指出，番茄可能会诱使痛风发作。本研究共纳入2051名痛风患者，其中71%的患者表示，至少有一种食物可诱发他们痛风发作。这些患者提出的“痛风食物”包括海鲜（62.54%）、酒精（47.06%）和红肉（35.18%）和西红柿（20.18%）（图1）。前三位是常见的为大家所熟知容易诱发痛风的食物，但意料之外的是，第四位居然西红柿，这让研究者始料不及。 为了进一步研究西红柿与血尿酸水平的关系，研究人员分析了另外3个来自于南美的研究（ARIC,、CHS、FHS）中欧洲白种人的样本，发现西红柿的摄入与血尿酸呈正相关（表1）。因此，研究者指出，尽管他们的描述性和观察性研究并不能确认西红柿可诱发痛风，但西红柿的摄入与血尿酸水平呈正相关的研究发现，在一定程度上支持了西红柿可作为诱发痛风的食物之一。

但是，西红柿属于低嘌呤食物，为什么也会导致血尿酸升高呢？研究人员猜测，西红柿中的酚酸会抑制肾脏排泄尿酸，致使血尿酸升高。另一个可能的原因是西红柿含有较多谷氨酸，为嘌呤合成提供原料氮，从而可以增强尿酸的合成。

当然，目前关于西红柿与尿酸、痛风发作的研究还非常少，也非常粗浅，仍有待更多的研究去探索和证实。现在可以给出的建议是，高尿酸或痛风患者避免摄入大量西红柿；同时，注意饮食、多饮水、适当运动、控制体重，遵照医生建议控制血尿酸水平。  

图1 患者报告的可诱发痛风的食物种类频率

表1 血清尿酸水平 (μmol/L)与番茄食用(摄入次数/周)的关系

原文摘要

来源：BMC Musculoskelet Disord. 2015 Aug 19;16:196. doi: 10.1186/s12891-015-0661-8.Positive association of tomato consumption with serum urate: support for tomatoconsumption as an anecdotal trigger of gout flares.Flynn TJ, Cadzow M, Dalbeth N, Jones PB, Stamp LK, Hindmarsh JH, Todd AS, Walker RJ, Topless R,Merriman TR.AbstractBACKGROUND:Gout is a consequence of an innate immune reaction to monosodium urate crystals deposited in joints. Acute gout attacks can be triggered by dietary factors that are themselves associated with serum urate levels.Tomato consumption is an anecdotal trigger of gout flares. This study aimed to measure the frequency of tomatoconsumption as a self-reported trigger of gout attacks in a large New Zealand sample set, and to test the hypothesis that tomato consumption is associated with serum urate levels.METHODS:Two thousand fifty one New Zealanders (of Māori, Pacific Island, European or other ancestry) with clinically-ascertained gout were asked about gout trigger foods. European individuals from the Atherosclerosis Risk In Communities (ARIC; n = 7517) Study, Cardiovascular Health Study (CHS; n = 2151) and Framingham Heart Study (FHS; n = 3052) were used to test, in multivariate-adjusted analyses, for association between serum urate andtomato intake.RESULTS:Seventy one percent of people with gout reported having ≥1 gout trigger food. Of these 20% specifically mentioned tomatoes, the 4(th) most commonly reported trigger food. There was association between tomato intake and serum urate levels in the ARIC, CHS and FHS combined cohort (β = 0.66 μmolL(-1) increase in serum urate per additional serve per week; P = 0.006) - evident in both sexes (men: β = 0.84 μmolL(-1), P = 0.035; women: β = 0.59 μmolL (-1), P = 0.041).CONCLUSIONS:While our descriptive and observational data are unable to support the claim that tomatoconsumption is a trigger of gout attacks, the positive association between tomato consumption and serum urate levels suggests that the self-reporting of tomatoes as a dietary trigger by people with gout has a biological basis.