Background: Increased uric acid is an independent risk factor for cardiovascular disease in obese adults and adolescents. The relationship between uric acid and atherosclerotic risk early in life is unknown.
Objective and hypotheses: We investigated whether uric acid relates to carotid intimamedia thickness (cIMT), a marker of preclinical atherosclerosis, in a rather large sample of school-age children and investigated the interaction of obesity status and fat distribution.
Method: Subjects were 635 asymptomatic Caucasian children (330 boys and 305 girls; mean age 8.3 years), of whom, 405 were lean, 125 were overweight and 105 were obese. Serum uric acid levels, insulin (and HOMA index of insulin resistance (HOMA-IR)), C-reactive protein (CRP) and fasting lipids (triacylglycerol and HDL-cholesterol) were quantified is fasting serum samples. BMI, waist circumference, systolic blood pressure (SBP), and both abdominal fat, and cIMT (by ultrasound) were also assessed.
Results: Overweight and obese children had higher uric acid levels and higher cIMT than lean children (P<0.0001). Uric acid was associated with several cardiovascular risk factors, namely, lower HDL-cholesterol and higher HOMA-IR, C-reactive protein, triacylglycerol, BMI, waist, SBP, abdominal fat and cIMT (all P<0.0001). Both obesity and abdominal fat showed interactions in the association with cIMT, as uric acid was preferentially related to cIMT in obese children (n=105; β;=0.396, P<0.0001, r2=15.7%) and in children with higher abdominal fat (n=221; β;=0.287, P<0.0001, r2=13.9%).
Conclusion: Increased serum uric acid is associated with cIMT in school-age children. Both obesity and increased abdominal fat aggravate the risk of atherosclerotic disease imposed by higher uric acid.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology