儿童和青少年肥胖患者的尿酸和γ -谷氨酰转移酶:与人体测量指标和心脏代谢风险标志物的关联，这取决于青春期、性别、体重减轻程度和患者护理类型:对肥胖患者随访登记的评估

IF 2.7 3区医学 Q1 PEDIATRICS

Pediatric Obesity Pub Date : 2022-11-06 DOI:10.1111/ijpo.12989

Susann Weihrauch-Blüher, Susanna Wiegand, Paul Weihe, Nicole Prinz, Daniel Weghuber, Georg Leipold, Almut Dannemann, Lara Bergjohann, Thomas Reinehr, Reinhard W. Holl, for the APV study group

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引用次数: 3

摘要

目的研究体重指数(BMI)-标准差评分(SDS)/腰高比(WHtR)与(i)血清尿酸(sUA)/ γ -谷氨酰胺转移酶(GGT)和(ii)肥胖儿童心脏代谢危险标志物之间的关系，考虑性别、青春期发育、体重减轻程度/患者护理类型。方法102936例儿童肥胖随访登记(APV;包括47%的男孩)。分析sUA/GGT与人体测量学、转氨酶、血脂、空腹胰岛素(FI)、胰岛素抵抗稳态模型评估(HOMA-IR)、甘油三酯与HDL-胆固醇(TG/HDL)比值之间的关系。随访分析(基线后3-24个月)认为BMI-SDS降低≥0.2 (n = 11096)或≥0.5 (n = 3728)。将青春期发育因素考虑在内，对性别与BMI-SDS进行了局部相关分析。结果基线时，BMI-SDS与sUA相关性最强(r = 0.35;n = 26 529)， HOMA-IR/FI (r = 0.30;n = 5513 /n = 5880)， TG/HDL-ratio (r = 0.23;n = 24 501)， WHtR与sUA的比值(r = 0.32;n = 10 805)， GGT (r = 0.34;n = 11862)和丙氨酸转氨酶(ALAT) (r = 0.33;n = 11 821)，其中男孩(WHtR和GGT: r = 0.36, n = 5793)和青春期前儿童(r = 0.36;n = 2216)。GGT和sUA(剔除年龄、性别、BMI-SDS的部分影响后)与TG/ hdl -比值相关(r = 0.27;n = 24501)。当BMI-SDS降低≥0.2或≥0.5时，GGT与天冬氨酸转氨酶(ASAT)/ ALAT关系最为密切，在青春期前和体重减轻时最为明显，并且与TG/ hdl -比值(r = 0.22;n = 1528)。青春期前儿童BMI-SDS/WHtR与GGT相关性最强。ΔBMI-SDS与ΔsUA强相关(r = 0.30;n = 4160)和ΔGGT (r = 0.28;n = 3562)，从ΔWHtR到ΔGGT (r = 0.28;N = 3562)(均p < 0.0001)。结论腹型肥胖可诱发青春期前高尿酸血症及肝脏受累。这在婴儿期可能比迄今预期的更强烈。即使是适度的减肥对心脏代谢风险概况和葡萄糖稳态也有有利的影响。

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Uric acid and gamma-glutamyl-transferase in children and adolescents with obesity: Association to anthropometric measures and cardiometabolic risk markers depending on pubertal stage, sex, degree of weight loss and type of patient care: Evaluation of the adiposity patient follow-up registry

Objectives

Associations between body mass index (BMI)- standard deviation score (SDS)/waist-to-height ratio (WHtR) were studied with (i) serum uric acid (sUA)/gamma-glutamyl-transferase (GGT) and (ii) cardiometabolic risk markers in children with obesity, considering sex, pubertal development, and degree of weight loss/type of patient care.

Methods

102 936 children from the Adiposity-Follow-up registry (APV; 47% boys) were included. Associations were analysed between sUA/GGT and anthropometrics, transaminases, lipids, fasting insulin (FI), homeostasis model assessment of insulin resistance (HOMA-IR), triglycerides to HDL-cholesterol (TG/HDL)-ratio.

Follow-up analyses (3–24 months after baseline) considered a BMI-SDS reduction ≥0.2 (n = 11 096) or ≥0.5 (n = 3728). Partialized correlation analyses for sex and BMI-SDS were performed, taking pubertal development into consideration.

Results

At baseline, BMI-SDS showed the strongest correlations to sUA (r = 0.35; n = 26 529), HOMA-IR/FI (r = 0.30; n = 5513 /n = 5880), TG/HDL-ratio (r = 0.23; n = 24 501), and WHtR to sUA (r = 0.32; n = 10 805), GGT (r = 0.34; n = 11 862) and Alanine-aminotransferase (ALAT) (r = 0.33; n = 11 821), with stronger correlations in boys (WHtR and GGT: r = 0.36, n = 5793) and prepubertal children (r = 0.36; n = 2216). GGT and sUA (after partializing effects of age, sex, BMI-SDS) showed a correlation to TG/HDL-ratio (r = 0.27; n = 24 501).

Following a BMI-SDS reduction ≥0.2 or ≥0.5, GGT was most strongly related to Aspartate-aminotransferase (ASAT)/ ALAT, most evident in prepuberty and with increasing weight loss, and also to TG/HDL-ratio (r = 0.22; n = 1528). Prepubertal children showed strongest correlations between BMI-SDS/WHtR and GGT. ΔBMI-SDS was strongly correlated to ΔsUA (r = 0.30; n = 4160) and ΔGGT (r = 0.28; n = 3562), and ΔWHtR to ΔGGT (r = 0.28; n = 3562) (all p < 0.0001).

Conclusion

Abdominal obesity may trigger hyperuricemia and hepatic involvement already in prepuberty. This may be stronger in infancy than anticipated to date. Even moderate weight loss has favourable effects on cardiometabolic risk profile and glucose homeostasis.

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来源期刊

Pediatric Obesity PEDIATRICS-

CiteScore

7.30

自引率

5.30%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Pediatric Obesity is a peer-reviewed, monthly journal devoted to research into obesity during childhood and adolescence. The topic is currently at the centre of intense interest in the scientific community, and is of increasing concern to health policy-makers and the public at large. Pediatric Obesity has established itself as the leading journal for high quality papers in this field, including, but not limited to, the following: Genetic, molecular, biochemical and physiological aspects of obesity – basic, applied and clinical studies relating to mechanisms of the development of obesity throughout the life course and the consequent effects of obesity on health outcomes Metabolic consequences of child and adolescent obesity Epidemiological and population-based studies of child and adolescent overweight and obesity Measurement and diagnostic issues in assessing child and adolescent adiposity, physical activity and nutrition Clinical management of children and adolescents with obesity including studies of treatment and prevention Co-morbidities linked to child and adolescent obesity – mechanisms, assessment, and treatment Life-cycle factors eg familial, intrauterine and developmental aspects of child and adolescent obesity Nutrition security and the "double burden" of obesity and malnutrition Health promotion strategies around the issues of obesity, nutrition and physical activity in children and adolescents Community and public health measures to prevent overweight and obesity in children and adolescents.