This study examined the association of serum uric acid (UA) with levels of cardiometabolic risk factors in overweight and moderate obese children and adolescents.
Three hundred and thirty three Caucasians of both sexes (149 females), of European origin, from 5 to 18 years of age (mean age 11.4 2.6) were included. Overweight and obesity were defined based on the extended international body mass index cut-offs. The subjects were divided into 3 groups according to serum UA: <5 mg/dl n = 118 subjects (35%); UA 5-6 mg/dl n = 130 subjects (39%) or UA>6 mg/dl n = 85 subjects (26%). Fasting blood was obtained and uric acid, glucose, insulin, and lipid profile, were measured. Likewise office BP and 24-hour ABPM were assessed. Hyperinsulinemia was defined from norms for pubertal stage. Abnormal fasting lipids were defined from normative data (Daniels et al, 2008). Subjects were qualified as normotensive, high-normal or hypertensive according to the ESH criteria (Lurbe et al, 2016).
There were significant differences among groups regarding, BMI, waist, fasting insulin, office SBP and night-time SBP increasing progressively across the serum UA groups. Controlling by age and sex, uric acid was significantly correlated with BMI (r = 0.27, p = 0.000), waist (r = 0.33; p = 0.000), birth weight (r = −0.11; p = 0.05), office SBP (r = 0.21; p = 0.000), daytime SBP, (r = 0.16; p = 0.03), nighttime SBP (r = 0.24; p = 0.000), insulin (r = 0.25; p = 0.000), and Log Tryglicerides (r = −0.137; p = 0.019). In a multiple regression analysis sex, waist, birth weight, SBP (office, daytime and nighttime), were independent determinants of uric acid when age, BMI, HDL-C and insulin were included (R2 = 0.29). The prevalence of hyperinsulinemia, low HDL-C, high-normal BP, and hypertension in each UA group are shown in the Figure.
In overweight and moderate obese children and adolescents there is a trend toward greater prevalence of cardiometabolic risk factors as the uric acid values rose. The role of hyperuricemia and its association with cardiometabolic risk factors should receive more attention, beginning in early childhood.
1CIBEROBN, Health Institute Carlos III, Madrid, Spain
2Cardiovascular Risk Unit, Hospital General Universitario University of Valencia, Valencia, Spain
3INCLIVA Research Institute, Valencia, Spain
4Dipartimento Cardio-Toraco-Vascolare, Università di Bologna, Ospedale Policlinico S.Orsola-Malpighi, Bologna, Italy