Moulin-Mares Stephanie R A, Zaniqueli Divanei, Oliosa Polyana R, Alvim Rafael O, Bottoni Juliana P, Mill José G
Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
Postgraduate Program in Public Health, Federal University of Espírito Santo (UFES), Vitória, ES, Brazil.
Pediatr Res. 2021 May;89(7):1855-1860. doi: 10.1038/s41390-020-01185-9. Epub 2020 Oct 8.
Our purpose was to determine reference values and determinants of serum uric acid (SUA) in children and adolescents.
A fasting blood sample was collected from 1750 schoolchildren and adolescents (6-17 years). Puberty was defined according to the Tanner scale. Bodyweight, muscle mass, and body fat percentage were determined by bioimpedance. Data are given as cut-offs and mean ± standard deviation.
SUA level was higher in children that had already entered puberty (4.2 ± 1.1 mg/dL) than among prepubescent (3.6 ± 0.8 mg/dL; p < 0.01). Considering the 90 percentile (p90) as the upper reference value, the following values are proposed for boys and girls, respectively: <10 years or prepubescent: ≤4.5 mg/dL and ≤4.8 mg/dL; from 10 to 13 years: ≤5.7 mg/dL and ≤5.2 mg/dL; from 14 to 17 years: ≤6.4 mg/dL and ≤5.3 mg/dL. Muscle mass explained part of the variability in SUA after pubescence, acting as an independent variable for higher levels of SUA.
The sex, age, and phase of puberty influence SUA reference levels, and part of this influence could be explained by the higher muscle mass, mainly after the adolescence onset.
The key message of this study is that high levels of uric acid in the blood are associated with metabolic syndrome and cardiovascular risk factors. These diseases should be prevented since the infancy However, it is necessary to establish reference values of uric acid (SUA) for children and adolescents. The Brazilian population is highly admixed and these values were not determined so far. We studied a robust sample of Brazilian schoolchildren and adolescents (6-17 years) and defined the 90th percentile of uric acid as the upper limit of normality for sex, age, and pubertal stage. These values can be used as a reference for other populations with similar characteristics.
我们的目的是确定儿童和青少年血清尿酸（SUA）的参考值及决定因素。
采集了1750名6至17岁学童和青少年的空腹血样。根据坦纳量表定义青春期。通过生物电阻抗法测定体重、肌肉量和体脂百分比。数据以临界值及均值±标准差表示。
已进入青春期的儿童SUA水平（4.2±1.1mg/dL）高于青春期前儿童（3.6±0.8mg/dL；p<0.01）。将第90百分位数（p90）作为上限参考值，分别为男孩和女孩提出以下值：<10岁或青春期前：≤4.5mg/dL和≤4.8mg/dL；10至13岁：≤5.7mg/dL和≤5.2mg/dL；14至17岁：≤6.4mg/dL和≤5.3mg/dL。青春期后，肌肉量解释了SUA变异性的部分原因，是SUA水平升高的一个独立变量。
性别、年龄和青春期阶段会影响SUA参考水平，部分影响可由更高的肌肉量来解释，主要是在青春期开始后。
本研究的关键信息是血液中尿酸水平升高与代谢综合征和心血管危险因素相关。这些疾病应从婴儿期就开始预防。然而，有必要确定儿童和青少年尿酸（SUA）的参考值。巴西人口高度混合，目前尚未确定这些值。我们研究了巴西6至17岁学童和青少年的一个规模可观的样本，并将尿酸的第90百分位数定义为按性别、年龄和青春期阶段划分的正常上限。这些值可作为具有相似特征的其他人群的参考。
