학술논문

Asymptomatic Hyperuricemia Associates with Cardiometabolic Risk Indicators in Overweight/Obese but Not in Lean Adolescents
Document Type
article
Source
Diabetes, Metabolic Syndrome and Obesity, Vol Volume 13, Pp 3977-3992 (2020)
Subject
uric acid
continuous cardiometabolic score
sex-difference
obesity
lean phenotype
Specialties of internal medicine
RC581-951
Language
English
ISSN
1178-7007
Abstract
Katarina Sebekova,1 Radana Gurecka,1,2 Ludmila Podracka3,4 1Institute of Molecular BioMedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; 2Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia; 3Department of Pediatrics, Faculty of Medicine, Comenius University, Bratislava, Slovakia; 4The National Institute of Children’s Health, Bratislava, SlovakiaCorrespondence: Katarina SebekovaInstitute of Molecular BioMedicine, Medical Faculty, Comenius University, Sasinkova 4, 811 08 Bratislava, SlovakiaTel +421-2-9011-9429Fax +421-2-9011-9631Email kata.sebekova@gmail.comPurpose: In overweight/obese adolescents, asymptomatic hyperuricemia is associated with increased prevalence of metabolic syndrome, its components, and a higher cardiometabolic risk. Whether similar associations exist in lean hyperuricemic adolescents is unknown.Subjects and Methods: In 2424 adolescents (51.9% females) aged 16– 19 years, anthropometric variables, blood pressure, uric acid, glucose, insulin, lipid profile, inflammatory markers, and renal function were determined. Continuous cardiometabolic score was calculated. Normouricemic vs hyperuricemic subjects were compared among lean and overweight/obese individuals of both sexes.Results: Females (5.4%) and males (13.3%) presented with hyperuricemia; among them 63% of females and 53% of males were lean. In both sexes, hyperuricemic lean and hyperuricemic overweight/obese adolescents displayed similar uric acid concentrations (eg, males: 455± 30 vs 461± 32 μmol/L, respectively, p=0.933). Lean normouricemic adolescents manifested significantly lower uric acid levels than their overweight/obese peers (eg, males: 333± 46 vs 357± 41 μmol/L, respectively, p< 0.001). Lean normouricemic and hyperuricemic subjects presented similar cardiometabolic score (eg, males: 2.60± 0.67 vs 2.64± 0.60, respectively, p=0.998); among overweight/obese adolescents those with hyperuricemia displayed higher scores compared with their normouricemic counterparts (eg, males: 3.36± 1.04 vs 4.21± 1.65, respectively, p< 0.001). A decision-tree model revealed phenotypes associated with higher uricemia, however, distribution of individuals with hyperuricemia among phenotypes was random.Conclusion: In lean adolescents, hyperuricemia is not associated with cardiometabolic profile indicating an increased risk. Existence of this rather prevalent phenotype remains undetected unless lean and overweight/obese subjects are analyzed separately. Longitudinal studies are needed to elucidate the potential clinical consequences of asymptomatic hyperuricemia in lean subjects in later life.Keywords: uric acid, continuous cardiometabolic score, sex-difference, obesity, lean phenotype