Original Article

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

10.4274/jcrpe.galenos.2019.2018.0241

  • Deniz Özalp Kızılay
  • Semra Şen
  • Betül Ersoy

Received Date: 08.11.2018 Accepted Date: 10.02.2019 J Clin Res Pediatr Endocrinol 0;0(0):0-0 [e-Pub]

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). 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 microalbuminuria were notassociated with SUAL in our study analyzes. SUAL showed significantly positive correlation with waist circumference (WC), WHR, post-challenge glucose level at 60 minute, fasting insulin, post-challenge insulin levels at 30, 60, 90 and 120 minutes, HOMA-IR, Total cholesterol / HDL-c ratio,TG/ HDL-c ratio and the number of criteria related to MetS, also inverse correlation with HDL-c.

Conclusions:

The presence of MetS, IR and dislipidemia rises with increasing SUAL independently of age, puberty, gender and body mass index (BMI) in OB/OW children. Patients with all of the MetS criteria had the highest SUAL. These results demonstrated that association between UA and metabolic and cardiovascular risk factors could be detectable as early as in childhood. Thus, we recommend monitoring SUAL in OB children and we believe that prevention of SUAL elevation in early life has a potential protective effect on metabolic impairment and subsequent comorbidities.

Keywords: Serum uric acid level, obesity, metabolic syndrome, insulin resistance, renal injury, cardiovascular risk, child