Abstract

PurposeObesity is a significant cause of morbidity in adolescents. Excess serum uric acid (SUA) has been associated with metabolic syndrome (MS) among adults. We evaluated the relationship among SUA and markers of insulin resistance (IR) and low-grade inflammation in obese adolescents with and without MS.MethodsThe study was a retrospective chart review of obese patients seen in the LeBonheur Endocrine clinic seen in clinic between September 2016 and December 2017. MS was defined as according to the International Diabetes Federation. Body mass index standard deviation score (BMI SDS), systolic blood pressure (SBP), diastolic blood pressure (DBP), body composition, fasting lipids, glucose, high sensitivity c-reactive protein (hs-CRP), serum uric acid (SUA), HbA1c, alanine transferase (ALT), aspartate transferase (AST), insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were extracted from the charts of the 100 obese adolescents (57% female).ResultsHyperuricemia (SUA >357 umol/L) was present in 41.8% of entire cohort without significant ethnic/racial and/or gender differences. Adolescents with HUA had higher FM, SBP, HbA1c, insulin and HOMA-IR (p < 0.05). While SUA was positively correlated with FM, SBP, HOMA-IR and HbA1c, and triglyceride:HDL-C ratio (TG:HDL-C) (p < 0.05). MS was identified in 32.8% of cohort. MS showed significantly higher FM, SBP, DBP, SUA, ALT, insulin, HOMA-IR, and TG:HDL-c ratio than non-MS subgroup (p < 0.05). FM was positively correlated with SUA, HOMA-IR and hsCRP (p < 0.01).ConclusionsIn our study, those with hyperuricemia (HUA) showed elevated markers of metabolic syndrome including BP, serum glucoses, IR and triglycerides. In our cohort, SUA appears to correlate with MS comorbidities.

Highlights

  • Obesity has been identified as significant public health concern over the past couple decades [1]

  • The metabolic interaction between serum uric acid (SUA) and low grade inflammation among adolescents has not been fully explored [23].we examined the differences in SUA and high sensitivity C-reactive protein (hsCRP) and indices of insulin resistance among adolescents with and without metabolic syndrome

  • Patients with MS were shown to have significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), Body mass index standard deviation score (BMI standard deviations scores (SDS)), Waist circumferences (WC), fat mass (FM), fasting insulin level, SUA, alanine transferase (ALT), total cholesterol, low-density lipoprotein cholesterol (LDL-C), and HOMA-insulin resistance (IR). (Table 2).There was no significant difference in GFR between those with metabolic syndrome and those without metabolic syndrome

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Summary

Methods

The study was a retrospective chart review of obese patients seen in the LeBonheur Endocrine clinic seen in clinic between September 2016 and December 2017. Body mass index standard deviation score (BMI SDS), systolic blood pressure (SBP), diastolic blood pressure (DBP), body composition, fasting lipids, glucose, high sensitivity c-reactive protein (hs-CRP), serum uric acid (SUA), HbA1c, alanine transferase (ALT), aspartate transferase (AST), insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were extracted from the charts of the 100 obese adolescents (57% female). Adolescents with HUA had higher FM, SBP, HbA1c, insulin and HOMA-IR (p < 0.05). While SUA was positively correlated with FM, SBP, HOMA-IR and HbA1c, and triglyceride:HDL-C ratio (TG:HDL-C) (p < 0.05). MS showed significantly higher FM, SBP, DBP, SUA, ALT, insulin, HOMA-IR, and TG:HDL-c ratio than non-MS subgroup (p < 0.05). Conclusions In our study, those with hyperuricemia (HUA) showed elevated markers of metabolic syndrome including BP, serum glucoses, IR and triglycerides.

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