Impact of bariatric surgery on serum uric acid levels and the incidence of gout—A meta‐analysis

Abstract

Gout is characterized by high serum uric acid (SUA) levels and arthritis. It is associated with obesity and metabolic syndrome. Bariatric surgery has been associated with decreased SUA levels and overall gout incidence. This meta-analysis aims to summarize the current evidence on bariatric surgery, gout and SUA levels. A literature review was performed on papers published from 2000 up till December 2018.Original studies investigating the impact of bariatric surgery on SUA levels or gout incidence were evaluated. Twenty studies with a total of 5,233 patients were analysed. Majority (n=14) had a follow-up duration of at least 12 months. The mean preoperative body mass index (BMI) was 45.2kg m −2 . The mean preoperative SUA level was 6.5mg dL −1 . Subgroup analysis demonstrated a mean decrease in SUA levels (−0.73mg dL −1 ) from the third postoperative month onwards, which was sustained until the third postoperative year (−1.91mg dL −1 ). There was a rise in SUA levels in the first post-operative month. Meta-regression analyses demonstrated a proportionate linear relationship between the change in BMI and SUA levels. Postbariatric surgery weight loss is associated with reduced SUA levels and decreased incidence of gout attacks. However, this is only evident from the third postoperative month onwards.

<p>Urine Glucose Excretion Attenuates the Association Between Lipid Accumulation Product and Serum Uric Acid in Subjects with Prediabetes</p>

“…33,34 However, weight reduction was shown to be associated with a significant decrease in UA levels. 11,12 In this study, we confirmed the possible interdependent relationship between UGE and LAP in predicting hyperuricemia.…”

“…Of these risk factors, obesity has a clear effect on UA levels. 11,12 However, in recent years, the distribution of fat accumulation in the body, rather than overweight or obesity per se, is becoming increasingly important for a variety of physiological aberrations. [13][14][15] Many studies did not consider the impact of fat distribution on UA levels.…”

“…9,10 The levels of serum UA tend to rise with weight gain, while declining with weight reduction. 11,12 Our recent research also found that individuals with elevated body mass index (BMI) were at increased risk for hyperuricemia. 1 BMI is widely used to identify overweight or obesity, but it is unable to estimate body fat distribution.…”

Very Low-Calorie Ketogenic Diet: A Safe and Effective Tool for Weight Loss in Patients with Obesity and Mild Kidney Failure

“…These controversial results might find their explanation in timing and weight loss amplitude, as food groups that typically increase serum uric acid levels are widely consumed in ketogenic diets and might lead to such an effect in the short term [24]. However, it is acknowledged that weight loss is associated with a significant reduction in urate levels [25]. As our patients experienced a mean weight loss of nearly 20% of baseline values, it seems reasonable to conclude that this aspect might have played a predominant role in modulating uric acid levels.…”

COVID-19 and Obesity—the Management of Pre- and Post-bariatric Patients Amidst the COVID-19 Pandemic

“…Bariatric surgery is currently an effective treatment modality for obesity and associated metabolic syndrome [1,2]. However, in this unprecedented global crisis, it is important that nonurgent clinic appointments and operations be postponed in order to conserve resources and reduce risks of viral transmission [3].…”