Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents

Abstract

Background: Metabolically healthy obesity (MHO) refers to those individuals who do not show cardiometabolic abnormalities. Our aim was to identify potential clinical and metabolic indicators that may help to distinguish between metabolically healthy and unhealthy individuals amongst overweight and obese children and adolescents. Methods: The study involved 246 overweight/obese and 212 normal-weight individuals enrolled in the LIFE Child study, aged between 6 and 18 years. Overweight/obese individuals without cardiovascular risk factors (fasting serum lipids, blood pressure, and glucose) were classified as MHO. Individuals meeting 1 or more criteria of cardiovascular risk factors were classified as metabolically unhealthy obesity (MUO). Results: Among the 246 overweight/obese individuals, 173 (70%) were MHO and 73 (30%) were MUO. The MHO individuals were younger, more likely to be male, and had lower BMI SDS. In the logistic regression models, uric acid (UA) SDS (OR 1.61, 95% CI 1.1–2.6, p = 0.004), waist circumference SDS (OR 2.50, 95% CI 1.2–6.4, p = 0.017), and C-peptide (OR 4.05, 95% CI 3.5–91, p = 0.003) were significant indicators of MUO. Conclusion: Our results suggest that nearly one-third of overweight/obese children are already identified as MUO. Serum levels of UA can be used as an indicator of unhealthy obesity in youth, where lower levels of UA indicate a lower risk and higher levels suggest a higher risk of MUO. We note that the relevance of identifying potential indicators remains the first most important step in future clinical research.

Healthy Obese Subjects Differ in Chronotype, Sleep Habits, and Adipose Tissue Fatty Acid Composition from Their Non-Healthy Counterparts

“…Uric acid concentrations were found to be lower in MHO than in MUO and, regardless of their BMI, subjects with the MHO phenotype always had lower uric acid concentration. Most studies of MHO and serum uric acid have been performed in adolescents, with similar results [64,65]. Moreover, uric acid has been proposed as a biomarker to distinguish MHO and MUO subjects [63].…”

Fructose and Uric Acid: Major Mediators of Cardiovascular Disease Risk Starting at Pediatric Age

“…In youth, serum uric acid increases progressively from an early age with body growth and reaches a plateau at around 15–17 years [ 40 ]. It has been shown to be significantly higher in overweight/obese children than in their normal-weight peers and to be of particular significance as a predictor of metabolically unhealthy status in young populations [ 41 ]. In fact, serum uric acid has been associated with an increased cardiovascular risk in light of its ability to induce endothelial dysfunction, in particular, through a reduction in nitric oxide production and anti-proliferative effects on the endothelium [ 42 ].…”

“…Serum uric acid seems to represent a useful indicator to identify children subject to cardio-metabolic risk, and its use has been proposed to discriminate between metabolically healthy and metabolically unhealthy obesity. Nevertheless, large-scale longitudinal studies are needed to confirm that uric acid is a marker of the metabolic phenotypes associated with harmful obesity [ 41 ].…”

Can Uric Acid Be A Marker For Metabolically Unhealthy Obesity in Children and Adolescents?

“…That is why studies focus on identifying new biomarkers that can distinguish different phenotypes of obesity to achieve improvements in the early period of life in obese adults, adolescents, and children (6,8). Recently, biomarkers, such as serum uric acid (UA) are claimed to be related to the development of metabolic syndrome, type 2 diabetes mellitus, and cardiovascular events in metabolically unhealthy obesity (MUO) in children and adolescents (6). However, it is emphasized that more studies are needed on this subject.…”