The effect of allopurinol on the hyperuricemia of fasting

Abstract

F asting obese subjects were treated with allopurinol or probenecid in order to prevent systemic and renal complications of hyperuricemia. Allopurinol in a dose of 600 mg. per day curbed excessive urate synthesis during early fasting. Renal urate excretion in the allopurinol-treated subjects was the same as that of untreated patients. Urinary oxypurine excretion increased 400 per cent during administration of allopurinol. When 600 mg. of allopurinol per day was given during the first month of fasting and 300 mg. per day during the second month, a uricosuric agent was not needed. Stable and neal' normal serum urate levels during the second month of fasting could be maintained in some subjects with the aid of uricosuric probenecid, permitting a gross estimate of a daily urate turnover rate of 480 to 500 mg. This suggests that during prolonged fasting, the initially accelerated catabolism of nucleoprotein decreases, although to a lesser degree than that of body protein in general.

Effects of Protein-Sparing Modified Fasting on Obese Japanese Patients

“…Furthermore, an increase in plasma uric acid was observed when uric acid excretion was decreased, suggesting that increase in the former during semistarvation might be partly due to decreased excretion of uric acid. These results also suggest that ketone bodies might directly inhibit the excretion of uric acid from the kidney, which is consistent with Drenick's observation [26]. The excessive accumulation of uric acid is thought to result from accelerated protein breakdown during the initial period of fasting [27] and from impairment of renal uric acid clearance [28,29].…”

The Effect of Starvation on the Concentration and Binding of Thyroxine and Triiodothyronine in Serum and on the Response to TRH

“…Of particular interest was the observation that serum triiodothyronine (T3) concentrations in such patients were depressed. These findings, together with the observation that oxygen consumption decreases during starvation (8,9), led us to conduct a prospective study of the effects of Submitted April 10, 1974 prolonged starvation on the concentration and binding of T4 and T3 in the serum of obese subjects. Observations on the effects of starvation on basal serum TSH and on the responses of the serum TSH and T3 concentrations to TRH were also made.…”