High-normal estimated glomerular filtration rate and hyperuricemia positively correlate with metabolic impairment in pediatric obese patients

Ricotti, Roberta; Genoni, Giulia; Giglione, Enza; Monzani, Alice; Nugnes, Martina; Zanetta, Sara; Castagno, Matteo; Marolda, Agostina; Bellomo, Giorgio; Bona, Gianni; Bellone, Simonetta; Prodam, Flavia

doi:10.1371/journal.pone.0193755

Cited by 23 publications

(13 citation statements)

References 35 publications

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“…In our study, we found a significant correlation between UA and glucose levels only at post challenge 60 minutes. Similarly Ricotti et al (36) showed that hyperuricemic patients were at increased risk of having a 1-hour post-OGTT glycemia which was also associated with increased metabolic risk.…”

Section: Discussionmentioning

confidence: 86%

Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight Children

Kızılay¹,

Şen

Ersoy

2019

Jcrpe

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Objective:The aim of this study was to assess the association between serum uric acid concentration (SUAC) and the parameters of the metabolic syndrome (MetS) and insulin resistance (IR). The secondary aim was to evaluate whether hyperuricemia is associated with renal injury and cardiovascular risk in obese (OB) and overweight (OW) children.Methods:The subjects of this study consisted of OB/OW children and adolescents (ages: 8-18 years). Sex and age specific serum uric acid (SUA) olarak değiştirilecek percentiles were used and a SUA >75th percentile was accepted as hyperuricemia. Anthropometric data, blood pressure (BP) measurements and biochemical parameters, including fasting blood glucose, insulin, total cholesterol, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol, triglycerides (TG), aspartate aminotransferase, alanine aminotransferase, homeostatic model assessments of IR (HOMA-IR) and SUAC were recorded. Oral glucose tolerance tests (OGTT) were performed in all patients. MetS was defined according to the International Diabetes Federation criteria. Total cholesterol/HDL-c ratio >4 and TG/HDL-c ratio >2.2 were used as the atherogenic index (AI) indicating cardiovascular risk. Urinary albumin excretion in a 24-hour and also in a first-morning urine sample were measured. Renal injury was assessed by microalbuminuria according to the National Kidney Foundation criteria.Results:There were 128 participants; 52 (40%) had elevated (SUA >75th percentile) and 76 had (60%) normal SUAC. The mean±SD age was 13.1±2.6 years and 87 (67.4%) were female. The mean±SD weight was 73±18.97 kg and mean±SD height was 155.4±12.11 cm. There was no statistical difference between the groups with and without hyperuricemia in terms of age, sex, puberty stage and degree of obesity. Increased SUAC were significantly associated with higher waist-to-hip ratio (WHR), fasting insulin levels and insulin at 30 and 60 minutes during OGTT, HOMA-IR, lower HDL-c and presence of hypertriglyceridemia as well as with decreased HDL-c, increased AI, presence of IR and MetS. BP and microalbuminuria were not associated with SUAC. SUAC showed significant positive correlations with waist circumference, WHR, post-challenge glucose level at 60 minutes, with fasting insulin, post-challenge insulin levels at 30, 60, 90 and 120 minutes and also with HOMA-IR, total cholesterol/HDL-c ratio, TG/HDL-c ratio and a number of other criteria related to MetS. Also, an inverse correlation with HDL-c was noted.Conclusion:In OB/OW children frequency of MetS, IR and dislipidemia increases with increased SUAC, a finding independent of age, puberty, gender and body mass index. Patients meeting all of the MetS criteria had the highest SUAC. These results demonstrate that the association between UA and metabolic and cardiovascular risk factors can be detected early in childhood. Thus, we recommend monitoring SUAC in OB children and we believe that prevention of SUAC elevation in early life has a potential protective effect on metabolic impairment a...

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Section: Discussionmentioning

confidence: 86%

Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight Children

Kızılay¹,

Şen

Ersoy

2019

Jcrpe

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“…Association between lower glomerular filtration rate and higher uric acid levels has formerly been documented in overweight/obese children and adolescents. 12 , 13 Similarly, apparently healthy hyperuricemic adolescents and adults presented lower glomerular filtration rate compared with their normouricemic peers. 31 , 38 , 40 In these studies, including ours, the decline in glomerular filtration rate was within the normal range values, reaching 7–10%.…”

Section: Discussionmentioning

confidence: 99%

<p>Asymptomatic Hyperuricemia Associates with Cardiometabolic Risk Indicators in Overweight/Obese but Not in Lean Adolescents</p>

Šebeková¹,

Gurecká²,

Podracká³

2020

DMSO

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Purpose In overweight/obese adolescents, asymptomatic hyperuricemia is associated with increased prevalence of metabolic syndrome, its components, and a higher cardiometabolic risk. Whether similar associations exist in lean hyperuricemic adolescents is unknown. Subjects and Methods In 2424 adolescents (51.9% females) aged 16–19 years, anthropometric variables, blood pressure, uric acid, glucose, insulin, lipid profile, inflammatory markers, and renal function were determined. Continuous cardiometabolic score was calculated. Normouricemic vs hyperuricemic subjects were compared among lean and overweight/obese individuals of both sexes. Results Females (5.4%) and males (13.3%) presented with hyperuricemia; among them 63% of females and 53% of males were lean. In both sexes, hyperuricemic lean and hyperuricemic overweight/obese adolescents displayed similar uric acid concentrations (eg, males: 455±30 vs 461±32 µmol/L, respectively, p =0.933). Lean normouricemic adolescents manifested significantly lower uric acid levels than their overweight/obese peers (eg, males: 333±46 vs 357±41 µmol/L, respectively, p <0.001). Lean normouricemic and hyperuricemic subjects presented similar cardiometabolic score (eg, males: 2.60±0.67 vs 2.64±0.60, respectively, p =0.998); among overweight/obese adolescents those with hyperuricemia displayed higher scores compared with their normouricemic counterparts (eg, males: 3.36±1.04 vs 4.21±1.65, respectively, p <0.001). A decision-tree model revealed phenotypes associated with higher uricemia, however, distribution of individuals with hyperuricemia among phenotypes was random. Conclusion In lean adolescents, hyperuricemia is not associated with cardiometabolic profile indicating an increased risk. Existence of this rather prevalent phenotype remains undetected unless lean and overweight/obese subjects are analyzed separately. Longitudinal studies are needed to elucidate the potential clinical consequences of asymptomatic hyperuricemia in lean subjects in later life.

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“…In our study, we found a significant correlation between UA and glucose levels only at post challenge 60 minute. Similarly Ricotti et al (36), showed that hyperuricemic patients were at increased risk of having a 1 -hour post-OGTT glycemia which was also associated with increased metabolic risk.…”

Section: Resultsmentioning

confidence: 83%

Associations Between Serum Uric Acid Levels and Cardiometabolic Risk, Renal İnjury in Obese and Overweight Children

Kızılay¹,

Şen²,

Ersoy³

2019

Jcrpe

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What is already known on this topic?Higher uric acid (UA) is associated with the risk factors characterizing Metabolic syndrome (MetS) and also with fasting insulin and insulin resistance (IR) in obese (OB) adults and adolescents. All these factors are predictive for both cardiovascular diseases and type 2 diabetes. Despite the appearing role of UA in contributing to obesity-related comorbidities such as MetS, cardiovascular risk factors, and kidney diseases, studies in overweight (OW)/OB children are rare and the results of the studies are still controversial. What this study adds?This study confirms associations of elevated serum UA with greater waist-to-hip ratio, lower HDLcholesterol, hypertriglyceridemia, the presence of MetS and IR in OB and OW children. Moreover, the number of criteria related to MetS is significantly associated with the elevation of UA. ABSTRACT Objective:In this study we aimed to assess the association between serum uric acid (SUA) concentration and metabolic syndrome (MetS) parameters and insulin resistance (IR). Our second aim was evaluate whether hyperuricemia is related with renal injury and cardiovascular risk in obese (OB) and overweight(OW) children. Methods:This study was conducted on 128 OB/OW children and adolescents (ages: 8-18 years), of whom 52 (40%) with SUA elevation (SUA persantile>75), 76 with (60%) normal SUA level (SUAL). u n c o r r e c t e d p r o o f Sex and age specific SUA persantiles were used and SUA persantile>75 was defined as hyperurisemia. Anthropometric data, blood pressure (BP) measurements and biochemical parameters including fasting blood glucose, insulin, total cholesterol, highdensity lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), homeostatic model assessments of insulin resistance (HOMA-IR) and SUAL were recorded. Oral glucose tolerance tests (OGTT) were performed on all patients. MetS was defined according to the International Diabetes Federation (IDF) criteria. Totalcholesterol / HDL-c ratio > 4 and TG to HDL-c ratio >2.2 were used as atherogenicindex (AI) and considered as cardiovascular risk.Urinary albumin excretion in a 24-h urinecollection and in a first-morning urine sample were measured. Renal injury was assessed by microalbuminuria according to the National Kidney Foundation criteria. Results:The mean age of the participants was 13.1±2.6 years; 87(67,4%) were female and 41 (31,8%) were male. The mean weight and height of the subjects were 73 kg (SD±18.97 kg) and 155.4 cm (SD±12.11 cm) respectively. The group with hyperuricemia was not statistically different from the group without hyperuricemia in terms of age, sex, puberty stage and the degree of obesity. Increased SUAL were significantly associated with higher waist-to-hip ratio (WHR), insulin levels at fasting, 30th and 60th minutes of OGTT, HOMA-IR, lower HDL-c and presence of hypertriglyceridemia also with decreased HDL-c, increased AI, presence of IR and MetS. BP and mic...

show abstract

High-normal estimated glomerular filtration rate and hyperuricemia positively correlate with metabolic impairment in pediatric obese patients

Cited by 23 publications

References 35 publications

Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight Children

Associations Between Serum Uric Acid Concentrations and Cardiometabolic Risk and Renal Injury in Obese and Overweight Children

<p>Asymptomatic Hyperuricemia Associates with Cardiometabolic Risk Indicators in Overweight/Obese but Not in Lean Adolescents</p>

Associations Between Serum Uric Acid Levels and Cardiometabolic Risk, Renal İnjury in Obese and Overweight Children

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