Castillo-Durán Carlos, Sepúlveda A Cecilia, Espinoza G Aníbal, Rebollo G María Jesús, Le Roy O Catalina
Departamento de Pediatría, Facultad de Medicina Campus Centro, Universidad de Chile, Santiago, Chile.
Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago, Chile.
Rev Chil Pediatr. 2016 Jan-Feb;87(1):18-23. doi: 10.1016/j.rchipe.2015.07.022. Epub 2015 Oct 21.
Hyperuricaemia has been suggested as an additional metabolic factor in adult obese patients, but it has not been sufficiently studied in paediatric.
To assess the relationship between serum uric acid levels (SUAL) with the level of general and visceral obesity, and other biochemical parameters in children and adolescents of Santiago, Chile.
A cross sectional study was conducted on 770 children and adolescents (ages: 6-15 y.) from a public school in Santiago, Chile, of whom 227 (29%) were obese (BMI>2 SD, WHO growth standards). Ninety subjects were randomly selected and 77 with no other chronic disease (41 males) accepted to participate. Data was collected on weight, stature, abdominal circumference (AC), visceral adiposity using ultrasound, and other biochemical measurements including fasting glucose, insulin, serum lipids, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and SUAL.
The mean SUAL was 0.200±0.065 mmol/L, and was increased in children with hyperinsulinism (adjusted by age: 0.221±0.075 vs. 0.183±0.054 mmol/L; P<.01), with no significant differences according to HOMA. Differences were also found between children with ALT>or<26 U/mL: 0.238±0.070 vs. 0.178±0.054 mmol/L, P<.001. The logistic regression showed the increased SUAL was only associated with increased ALT. No significant differences were found in general or visceral adiposity measurements or fatty liver.
Children and adolescents from Santiago, Chile have higher uric acid serum uric acid levels as well as an association with increased ALT and insulin. It is demonstrated in this study that uric acid should be measured in obese children and adolescents, and in their follow up.
高尿酸血症被认为是成年肥胖患者的一个额外代谢因素，但在儿科方面尚未得到充分研究。
评估智利圣地亚哥儿童和青少年血清尿酸水平（SUAL）与总体及内脏肥胖水平以及其他生化参数之间的关系。
对智利圣地亚哥一所公立学校的770名儿童和青少年（年龄：6 - 15岁）进行了横断面研究，其中227名（29%）为肥胖儿童（BMI>2标准差，采用世界卫生组织生长标准）。随机选取90名受试者，77名无其他慢性病的受试者（41名男性）同意参与。收集了体重、身高、腹围（AC）、使用超声测量的内脏脂肪量以及其他生化指标的数据，包括空腹血糖、胰岛素、血脂、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）和SUAL。
SUAL的平均值为0.200±0.065 mmol/L，在高胰岛素血症儿童中升高（按年龄调整：0.221±0.075 vs. 0.183±0.054 mmol/L；P<.01），根据稳态模型评估胰岛素抵抗（HOMA）无显著差异。ALT>或<26 U/mL的儿童之间也存在差异：0.238±0.070 vs. 0.178±0.054 mmol/L，P<.001。逻辑回归显示SUAL升高仅与ALT升高相关。在总体或内脏肥胖测量或脂肪肝方面未发现显著差异。
智利圣地亚哥的儿童和青少年血清尿酸水平较高，且与ALT升高和胰岛素升高有关。本研究表明，应在肥胖儿童和青少年及其随访过程中测量尿酸。
