Uric Acid Is Elevated in Children With Obesity and Decreases After Weight Loss

Jørgensen, Rasmus; Bøttger, Bjarke; Vestergaard, Esben Thyssen; Kremke, Britta; Bahnsen, Rikke Frederiksen; Nielsen, Bent Windelborg; Bruun, Jens Meldgaard

doi:10.3389/fped.2021.814166

Cited by 23 publications

(16 citation statements)

References 35 publications

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“…Furthermore, differences in sex distribution, pubertal staging, adiposity severity, degree of central/ abdominal/visceral fat accumulation and insulin resistance as well as ethnicity might to some extent explain the variability in the prevalence of hyperuricemia and in its associations with metabolic syndrome and its components. Contrary to most other studies [20,27,38,44], we found no sex bias in hyperuricemia, even when divided by pubertal status, and SUA concentrations did not increase with age, BMI excess or waist circumference/height index. While a sex bias was inconsistent in pediatric obesity studies, the increase with age, BMI or waist circumference was a more constant nding [23,37,38,40].…”

Section: Discussioncontrasting

confidence: 99%

“…Additionally, increased uric acid production by adipose tissue is also likely to contribute to hyperuricemia in obese subjects [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Elevated SUA concentrations are reported in up to 40% of obese children or adolescents [16]. Insulin resistance appears to drive obesity associated hyperuricemia, probably by lowering renal uric acid excretion [17, 18].Additionally, increased uric acid production by adipose tissue is also likely to contribute to hyperuricemia in obese subjects [19,20].Both insulin resistance and hyperuricemia strongly correlate with abdominal or visceral adiposity, more than total or relative fat mass [12,13,[21][22][23][24][25][26]. The initial studies in obese children found sex bias in serum uric acid and metabolic syndrome [27].…”

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confidence: 99%

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Prevalence and determinants of hyperuricemia in multi-ethnic Belgian population of inner-city living children and adolescents with obesity

Nauwynck

Vanbesien

Staels

et al. 2022

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Background Hyperuricemia in childhood obesity associates variably with distinct components of the metabolic syndrome. We aimed to investigate the prevalence of hyperuricemia in an ethnically diverse pediatric obese population in Brussels using age and sex-specific serum uric acid (SUA) reference ranges. Methods We performed a cross-sectional analysis of data from overweight/obese children at Universitair Ziekenhuis Brussel between 2013 and 2017. Hyperuricemia was defined by a SUA above the assay specific and age and gender defined reference range. Results Among 388 children and adolescents, 9% were overweight, 16.2% had class I obesity, 27.8% had class II obesity and 46.9% had class III obesity. Median SUA was 4.8 mg/dL, with 20.6% patients showing an elevated SUA. Degree of general and central obesity, pubertal status, gender, descent and the presence of metabolic syndrome and insulin resistance were not significantly different between those with and without hyperuricemia. Median waist-to-height ratio, serum triglycerides and insulin resistance were significantly higher in Turkish children compared to children of other descent. Conclusion Hyperuricemia was not associated with age, ethnicity, severity of global/central obesity, metabolic syndrome or its components. Future studies should focus on investigating the association with diet composition, obesity duration and the eventual risk for cardiovascular complications.

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Section: Discussioncontrasting

confidence: 99%

“…Additionally, increased uric acid production by adipose tissue is also likely to contribute to hyperuricemia in obese subjects [19,20].…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence and determinants of hyperuricemia in multi-ethnic Belgian population of inner-city living children and adolescents with obesity

Nauwynck

Vanbesien

Staels

et al. 2022

Preprint

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“…Our data, showing a significant association between reduction of BMI z-score (and WtHr) and uric acid values at follow-up, seem to support this hypothesis and also suggest that, at least in pediatric ages, if an increase in weight leads to an increase in uric acid, its reduction can reverse at least in part the phenomenon. Another recent study performed in a population of children and adolescents with obesity demonstrated a reduction in uric acid levels in children who underwent a multifactorial lifestyle intervention and lost weight during the trial, and an increase in those who gained weight [ 46 ]. In our population, the higher the uric acid values at baseline, the lower the response to the intervention, and children with uric acid values > 90th percentile at baseline were six times more likely to be hyperuricemic even at follow-up.…”

Section: Discussionmentioning

confidence: 99%

Impact of Lifestyle Modifications on Alterations in Lipid and Glycemic Profiles and Uric Acid Values in a Pediatric Population

et al. 2022

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Cardiometabolic risk factors are frequent in children and adolescents with excess weight. The aim of this study was to evaluate the effects of lifestyle modifications on alterations in lipid and glycemic profiles and uric acid values in a pediatric population at increased cardiovascular risk. The study involved 276 subjects with a mean age of 10.6 (2.3) years. Body mass index (BMI) z-score and biochemical parameters (serum low-density lipoprotein (LDL) cholesterol, triglycerides and uric acid and homeostasis model assessment to quantify insulin resistance (HOMA index)) were assessed at baseline and at the end of a median follow-up of 14.7 (12.4, 19.3) months. Throughout follow-up, all children received a non-pharmacological treatment based on increased physical activity, reduced sedentary activity and administration of a personalized, healthy and balanced diet. All children attended periodic quarterly control visits during follow-up. Multivariable statistical analyses showed that each BMI z-score point reduction at follow-up was associated with an 8.9 (95%CI −14.2; −3.6) mg/dL decrease in LDL cholesterol (p = 0.001), 20.4 (95%CI −30.0; −10.7) mg/dL in triglycerides (p < 0.001), 1.6 (95%CI −2.2; −1.0) in HOMA index (p < 0.001), and 0.42 (95%CI −0.66; −0.18) mg/dL in uric acid (p = 0.001) values. At each reduction of the BMI z-score by one point, the odds of presenting with insulin resistance and hyperuricemia at follow-up significantly decreased (OR 0.23, 95%CI 0.10–0.50, and OR 0.32, 95%CI 0.10–0.95, p < 0.001 and p < 0.05, respectively). Improvement of dietary habits and lifestyles may improve lipid and glycemic profiles and serum uric acid values in a pediatric population.

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“…Indeed, increased marrow adiposity is attributed to the shift from osteogenic to adipogenic differentiation of bone marrow mesenchymal stem cells ( 22 ). However, obesity is also positively associated with HU ( 23 , 24 ). Experimental evidence did suggest that purine catabolism in adipose tissue could be enhanced in obesity ( 25 ).…”

Section: Introductionmentioning

confidence: 98%

Relationship between bone mineral density and hyperuricemia in obesity: A cross-sectional study

et al. 2023

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BackgroundObesity is an increasingly severe global public health issue. This study aims to estimate the cross-sectional association between bone mineral density (BMD) and hyperuricemia (HU) in obesity.MethodA total of 275 obese subjects (126 men and 149 women) participated in this cross-sectional study. Obesity was diagnosed as body mass index (BMI) ≥28 kg/m2, whereas HU was defined as the blood uric acid level of 416 μmol/L in men and 360 μmol/L in women. The BMD of the lumbar spine and right hip was measured by dual-energy X-ray absorptiometry (DXA). The multivariable logistic regressions were employed to examine the relationship between BMD and HU in obesity, with the adjustment of gender, age, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, creatinine, blood urea nitrogen, high-sensitivity C-reactive protein (hs-CRP), cigarette smoking, and alcohol drinking status.ResultThe overall prevalence of HU was 66.9% in this obese population. The mean age and BMI of this population were 27.9 ± 9.9 years and 35.2 ± 5.2 kg/m2, respectively. The multivariable-adjusted OR (the highest vs. lowest BMD quartile) demonstrated a negative relationship between BMD and HU in total (OR = 0.415, 95%CI: 0.182–0.946; p = 0.036), L1 (OR = 0.305, 95%CI: 0.127–0.730; p = 0.008), L2 (OR = 0.405, 95%CI: 0.177–0.925; p = 0.032), and L3 (OR = 0.368, 95%CI: 0.159–0.851; p = 0.020) lumbar vertebrae. In the subgroup analysis for the male population, the BMD was also negatively associated with HU in total (OR = 0.077, 95%CI: 0.014–0.427; p = 0.003), L1 (OR = 0.019, 95%CI: 0.002–0.206; p = 0.001), L2 (OR = 0.161, 95%CI: 0.034–0.767; p = 0.022), L3 (OR = 0.186, 95%CI: 0.041–0.858; p = 0.031), and L4 (OR = 0.231, 95%CI: 0.056–0.948; p = 0.042) lumbar vertebrae. However, such findings did not exist in women. In addition, there was no significant relationship between hip BMD and HU in obesity.ConclusionOur results showed that the lumbar BMD was negatively associated with HU in obesity. However, such findings only existed in men, rather than women. In addition, no significant relationship between hip BMD and HU existed in obesity. Due to the limited sample size and nature of the cross-sectional design, further large prospective studies are still needed to clarify the issues.

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Uric Acid Is Elevated in Children With Obesity and Decreases After Weight Loss

Cited by 23 publications

References 35 publications

Prevalence and determinants of hyperuricemia in multi-ethnic Belgian population of inner-city living children and adolescents with obesity

Prevalence and determinants of hyperuricemia in multi-ethnic Belgian population of inner-city living children and adolescents with obesity

Impact of Lifestyle Modifications on Alterations in Lipid and Glycemic Profiles and Uric Acid Values in a Pediatric Population

Relationship between bone mineral density and hyperuricemia in obesity: A cross-sectional study

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