Elevated Serum Uric Acid Predicts Metabolic Syndrome in Adolescents
Male adolescents with the highest uric acid levels at baseline were 6 times more likely to develop metabolic syndrome after 3 years than those with the lowest levels.
Elevated uric acid (UA) is one of a number of clinical abnormalities associated with the metabolic syndrome in adults and children. To examine this association in adolescents, researchers followed 613 randomly selected male adolescents (age range, 10–15 years) from a health screening center in Taiwan for a mean of 2.7 years. Baseline UA, waist circumference, blood pressure (BP), body-mass index (BMI), fasting plasma glucose, and cholesterol levels were measured at baseline and follow-up. Adolescents with metabolic syndrome, type 1 diabetes, hypertension, or hyperlipidemia at baseline were excluded.
Adolescents were divided into quartiles according to UA levels, ranging from lowest (mean, 5.2 mg/dL) to highest (mean, 8.9 mg/dL). Nineteen adolescents (3.1%) developed metabolic syndrome as defined by the International Diabetes Federation consensus criteria (>3 of the following: abdominal obesity, triglycerides 150 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, hypertension, and fasting plasma glucose 100 mg/dL). Age, waist circumference, BMI, BP, high-density lipoprotein cholesterol, and triglycerides were significantly associated with baseline UA. Risk for developing metabolic syndrome was significantly greater in adolescents in the highest UA quartile than in those in the lowest quartile (odds ratio, 6.39). The positive predictive value of a baseline UA value of 7.6 mg/dL for developing metabolic syndrome was 79% and the negative predictive value was 94%. Higher UA, waste circumference, and BP were independently predictive of metabolic syndrome at follow-up.
Comment: Uric acid is hypothesized to be an endothelial toxin and to play a role in the genesis of hypertension and metabolic syndrome. Although this is a relatively small study and the serum uric acid levels are surprisingly high, serum UA appears to be a marker in adolescents for developing metabolic syndrome.
Published in Journal Watch Pediatrics and Adolescent Medicine June 13, 2012
Wang J-Y et al. Predictive value of serum uric acid levels for the diagnosis of metabolic syndrome in adolescents. J Pediatr 2012 May 11; [e-pub ahead of print]. (http://dx.doi.org/10.1016/j.jpeds.2012.03.036)
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