Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Middle Yanchang Road, Shanghai, 200072, China.
Department of Endocrinology and Metabolism, YangPu Hospital, Tongji University School of Medicine, Shanghai, 200090, China.
Lipids Health Dis. 2018 Dec 20;17(1):288. doi: 10.1186/s12944-018-0934-y.
Hyperuricemia is related to obesity and fat accumulation. This study aimed to observe the effects of laparoscopic sleeve gastrectomy (LSG) on serum uric acid (sUA) level and body fat distribution in obese patients. The relationships between post-LSG improvement in sUA levels and body fat distribution changes, as well as their sex-related differences, were also explored.
In total, 128 obese patients (48 men; 80 women) who underwent LSG were enrolled. Anthropometric indicators, glucose and lipid metabolic indicators, and sUA levels were measured pre-LSG and 6 months post-LSG. The body compositions were measured via dual-energy X-ray absorptiometry. The patients were divided into normal-sUA (NUA) and high-sUA (HUA) groups based on preoperative sUA levels.
Compared with the NUA group, the reduction of sUA levels 6 months post-LSG was more significant in the HUA group. In addition, sUA reduction in the female HUA group was more significant than that of the male HUA group (P < 0.01). Changes in serum uric acid levels (ΔsUA) in the male HUA group was positively correlated with changes in body weight, body mass index, neck circumference, and hip circumference (r = 0.618, 0.653, 0.716, and 0.501, respectively; P < 0.05 in all cases). It was also positively correlated with changes in fat mass in the gynoid region, android region, and legs, (r = 0.675, 0.551, and 0.712, respectively; P < 0.05 in all cases), and negatively correlated with changes in total testosterone (ΔTT) (r = - 0.517; P = 0.040). Furthermore, ΔTT in this group was closely associated with the improved sex-related fat distribution. The ΔsUA in the female HUA group was positively correlated with changes in fasting serum C peptide and ΔLNIR (r = 0.449 and 0.449, respectively; P < 0.05 in both cases). In addition, it was also positively correlated with changes in visceral adipose tissue (VAT) fat mass, VAT fat volume, and VAT fat area (r = 0.749, 0.749, and 0.747, respectively; P < 0.01 in all cases).
sUA levels of obese patients with hyperuricemia improved 6 months after LSG. Reduction of sUA after LSG was correlated with improved body fat distribution, and the relationships also displayed sex-based differences. Uric acid might be an important metabolic regulator associated with fat distribution and sex hormones.
高尿酸血症与肥胖和脂肪堆积有关。本研究旨在观察腹腔镜袖状胃切除术（LSG）对肥胖患者血清尿酸（sUA）水平和体脂分布的影响。还探讨了 LSGS 后 sUA 水平改善与体脂分布变化之间的关系及其与性别差异的关系。
共纳入 128 例肥胖患者（48 名男性；80 名女性），均行 LSG。分别于术前和术后 6 个月测量体重指数、血糖和血脂代谢指标及 sUA 水平。采用双能 X 线吸收法测量体成分。根据术前 sUA 水平将患者分为正常 sUA（NUA）和高 sUA（HUA）组。
与 NUA 组相比，HUA 组术后 6 个月 sUA 水平降低更明显。此外，女性 HUA 组的 sUA 降低幅度大于男性 HUA 组（P<0.01）。男性 HUA 组血清尿酸水平变化（ΔsUA）与体重、体重指数、颈围和臀围变化呈正相关（r=0.618、0.653、0.716 和 0.501，P<0.05），与女性 HUA 组的变化呈正相关。与女性 HUA 组性腺区、腹型区和腿部脂肪质量的变化呈正相关（r=0.675、0.551 和 0.712，P<0.05），与总睾酮（ΔTT）的变化呈负相关（r=−0.517；P=0.040）。此外，该组的ΔTT 与改善的性别相关脂肪分布密切相关。女性 HUA 组的ΔsUA 与空腹血清 C 肽和 ΔLNIR 的变化呈正相关（r=0.449 和 0.449，P<0.05）。此外，它还与内脏脂肪组织（VAT）脂肪质量、VAT 脂肪体积和 VAT 脂肪面积的变化呈正相关（r=0.749、0.749 和 0.747，P<0.01）。
LSG 后，肥胖伴高尿酸血症患者的 sUA 水平在 6 个月后得到改善。LSG 后 sUA 的降低与体脂分布的改善有关，且这种关系存在性别差异。尿酸可能是与脂肪分布和性激素相关的重要代谢调节剂。
