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Serum uric acid and its association with metabolic syndrome and carotid atherosclerosis in obese children

Departments of¹ Pediatrics² , Radiological Sciences³ Laboratory Medicine, La Sapienza University of Rome, Viale Regina Elena, 324 00161 Rome, Italy⁴ Molecular Medicine, National Research Council, 00133 Rome, Italy

(Correspondence should be addressed to L Pacifico; Email: lucia.pacifico{at}uniroma1.it)

Objective: The association between hyperuricemia, metabolic syndrome (MS), and atherosclerotic vascular disease has been reported in adults, but very little is known about this association in children. The aims of our study were to ascertain the correlates of uric acid (UA) in a sample of obese children, and to investigate whether UA is associated with carotid intima-media thickness (IMT) independently from classical risk factors including MS.

Methods: We analyzed carotid IMT along with serum triglycerides, total and high-density lipoprotein cholesterol, glucose, insulin, insulin resistance index (as homeostasis model assessment of insulin resistance), alanine aminotransferase, -glutamyltransferase, creatinine, and UA in 120 obese children and 50 healthy control children.

Results: UA concentrations were significantly higher in obese children compared with controls; moreover, they correlated with the most established cardiovascular risk factors. In the group of obese children, after adjustment for age, sex, pubertal stage, and creatinine, an independent association between UA levels and the presence of MS syndrome was observed (unstandardized coefficient, 0.044 (95% confidence intervals (CI) 0.015–0.072); P<0.01). Carotid IMT significantly increased in the fourth quartile of UA compared with that in the first, second, and third quartile (0.49 (0.46–0.53), 0.53 (0.49–0.56), and 0.55 (0.52–0.59) vs 0.61 (95% CI, 0.58–0.64); P<0.01). When multivariate analysis was performed after adjusting for age, gender, pubertal stage, creatinine, and MS (considered as a single clinical entity), or the individual components of MS simultaneously included, the association between UA and carotid IMT was significant (P<0.01).

Conclusions: In obese children and adolescents, increased UA levels are associated with carotid atherosclerosis.