ESPE Abstracts

Background/ Aims: Hyperuricemia (HU) is a frequent finding in childhood obesity, ranging between 12 and 40%, and associates to a variable extent with different components of the metabolic syndrome (MS). In this study, the effect of gender, (a Belgian native vs a non-Belgian native) descent and degree of general and central adiposity on serum uric acid (SUA) and the prevalence of HU was investigated in a multi-ethnic population of overweight/obese children and adolescents living in/around Brussels, using an age and sex-specific SUA reference ranges.

Methods: Fasting morning serum concentrations of uric acid, glucose, insulin, total cholesterol, HDL cholesterol and triglycerides were measured in 388 overweight (BMI 1.3 – 2 SDS)/obese (BMI SDS > 2) children and adolescents, entering an ambulatory weight loss program. Routine anthropometry and blood pressure measurements were performed. SUA was measured by enzymatic colorimetry. HU was defined by a SUA above the assay specific and age and gender defined reference range. MS was defined by the IDF criteria. Insulin resistance was defined by a HOMA-IR >2.16 for prepubertal children and >3.6 for pubertal children.

Results: Their median age was 10.45 years (range 6-16). In total, 219/388 (56.4%) were females, 67/388 (17.2%) were pubertal or postpubertal, 65/388 (16.8%) subjects had MS, while insulin resistance was present in 258/388 (66.5%) subjects. Median SUA was 4.8 mg/dL and ranged between 0.5-9.5 mg/dl, with 80 (20.6 %) children and adolescents showing an elevated SUA. Degree of general obesity (BMI Z-score) and central adiposity (waist SDS), pubertal status (Prepubertal, pubertal and postpubertal), gender, descent (Belgian native and non-Belgian native origin), as well as the presence of MS and insulin resistance were not significantly different between those with and without hyperuricemia. Median waist-to-height ratio, serum triglycerides and insulin resistance were significantly (respectively P=0.011, P=0.006, P=0.008) higher in Turkish children/adolescents compared to Moroccan and children of other (mainly Belgian native) descent.

Conclusion: Hyperuricemia was present in one fifth of inner-city living overweight/obese children, irrespective of age ethnic background and severity of global or central obesity. No significant association between HU and metabolic syndrome or its different components was found. Future studies should focus on investigating the association with diet composition, obesity duration and degree of sedentary lifestyle and the eventual risk for cardiovascular complications.