Obesity-Induced Insulin Resistance Is Mediated by High Uric Acid in Obese Children and Adolescents

Abstract

ObjectiveThis study aimed to evaluate whether serum uric acid (SUA) plays a mediating role in the development of insulin resistance (IR) in obese children and adolescents.MethodsA total of 369 participants aged 4-17 years with obesity who attended the Nutrition Outpatient Clinic for Obesity at Xinhua Hospital from January 2012 to January 2019 were recruited for this retrospective study. We classified participants into two groups on the basis of HOMA-IR values: the low HOMA-IR group (< 3.16) (n = 222) and the high HOMA-IR group (≥ 3.16) (n = 147).ResultsThe univariate analysis found that the high HOMA-IR group had higher BMI, SUA, and fasting insulin (FINS) (P < 0.05). Multiple linear regression analysis and mediating effect analysis indicated that body mass index (BMI) could directly regulate FINS and HOMA-IR (both P < 0.05). The results from the mediating effect analysis found that UA partially played an indirect role in the link between BMI, FINS and HOMA-IR (both P < 0.05) but had no effect on fasting blood glucose (P > 0.05).ConclusionsSUA should be investigated in obesity and plays a partial mediating role in insulin resistance induced by obesity in obese children and adolescents.

Prevalence and determinants of hyperuricemia in multi-ethnic Belgian population of inner-city living children and adolescents with obesity

“…We speculate that the high prevalence of non-Belgian-natives, moderate degree of obesity and the low prevalence of metabolic syndrome in our sample decreased our power to investigate associations between hyperuricemia and components of the metabolic syndrome [23,29,40,44]. In some studies, a threshold effect in the association between SUA and components of the metabolic syndrome was found with strong correlations only in subjects with very high SUA [44].…”

“…Contrary to most other studies [20,27,38,44], we found no sex bias in hyperuricemia, even when divided by pubertal status, and SUA concentrations did not increase with age, BMI excess or waist circumference/height index. While a sex bias was inconsistent in pediatric obesity studies, the increase with age, BMI or waist circumference was a more constant nding [23,37,38,40].…”

“…Both insulin resistance and hyperuricemia strongly correlate with abdominal or visceral adiposity, more than total or relative fat mass [12,13,[21][22][23][24][25][26]. The initial studies in obese children found sex bias in serum uric acid and metabolic syndrome [27].…”

Skeletal Muscle Microvascular Dysfunction in Obesity-Related Insulin Resistance: Pathophysiological Mechanisms and Therapeutic Perspectives

“…Obesity and other insulin-resistant phenotypes are associated with hyperuricaemia [94][95][96]. High uric acid concentration has been suggested to induce endothelial dysfunction via the interaction of high-mobility group box chromosomal protein 1 with the receptor for advanced glycation end products (HMGB1/RAGE pathway).…”

Muscle Fat Content Is Strongly Associated With Hyperuricemia: A Cross-Sectional Study in Chinese Adults

“…Uric acid (UA) is a metabolic end-product of purine compounds, normal serum UA level is controlled by the balance between synthesis and excretion of urate. Clinical and epidemiological studies have suggested associations between increased UA level with obesity, hypertension, insulin resistance, dyslipidemia, liver dysfunction, renal dysfunction and gouty arthritis (1)(2)(3)(4)(5)(6)(7)(8), it was indicated that UA is a mediator of metabolic dysfunction (9,10), it also reflects prognosis of some diseases. In recent decades, Hyperuricemia (HUA) has become a common metabolic disorder worldwide.…”