Hyperuricemia: a reality in the Indian obese.

Centre for Obesity and Diabetes Surgery, H. Goregaonkar Road, Mumbai, India.
Obesity Surgery (Impact Factor: 3.1). 04/2012; 22(6):945-8. DOI: 10.1007/s11695-012-0655-7
Source: PubMed

ABSTRACT Hyperuricemia is known to be associated with obesity and metabolic syndrome. The aims of this study were to evaluate the prevalence of hyperuricemia in the Indian obese population and to determine if a correlation exists between hyperuricemia, body mass index, waist circumference and components of metabolic syndrome. This was a retrospective observational study. Four hundred nine obese patients were included. Anthropometric parameters were recorded. Prevalence of type 2 diabetes mellitus (T2DM), hypertension and dyslipidemia were recorded. Uric acid levels were measured in all patients. Hyperuricemia was defined as serum uric acid levels greater than 6 mg/dl. The population studied had a median body mass index (BMI) of 44.14 kg/m(2) (range 28.1-88.2 kg/m(2)) and a median age of 41 years (range 18 to 75 years). Overall prevalence of hyperuricemia was 44.6 %. Thirty-four percent in the BMI range of 28-35 kg/m(2) and 47 % of patients with a BMI of >35 kg/m(2) had hyperuricemia. The incidence of hyperuricemia in males was 50 vs 21.7 % in females. Of patients in the hyperuricemia group, 47.3 % had hypertension as compared to 37 % in the normouricemic group. Dyslipidemia was seen in 7.3 % of hyperuricemic patients as compared to 5.8 % of the normouricemic subjects. The prevalence of T2DM was comparable in both the groups. The Indian obese population has a significant high prevalence of hyperuricemia; the incidence of hyperuricemia in male patients was greater than in female patients. Central obesity had no direct link to hyperuricemia. There was no significant correlation between the occurrence of T2DM and dyslipidemia and hyperuricemia. Hypertension was the only comorbidity seen to occur in conjunction with hyperuricemia.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to investigate prevalences of hyperuricemia and the metabolic syndrome (MS) in the Hangzhou population, and the relationship between serum uric acid and the MS. A cross-sectional study was conducted among 4155 subjects (2614 men and 1541 women) aged 20-80 years, recruited through a health check program in Hangzhou, China. Biochemical and haematological parameters were measured by standard methods. The diagnosis of the MS is made when three or four of the following criteria are met: 1) body mess index (BMI) >or= 25; 2) systolic blood pressure >or= 140 mmHg or diastolic blood pressure >or= 90 mmHg; 3) fasting triacyglycerol >or= 1.7 mmol/L (150 mg/dL), high density lipoprotein cholesterol (HDL-C) < 0.9 mmol/L (35 mg/dL) in men and <1.0 mmol/L (39 mg/dL) in women; 4) fasting glucose >or= 6.1 mmol/L (109 mg/dL). Hyperuricemia is defined by cut-off values of > 420 mumol/L for men and > 360 mumol/L for women. Prevalences were 16.9% (N=702) for hyperuricemia and 8.4% (N=349) for the MS. Serum uric acid concentration was significantly higher in males than in females (p<0.0001), and significantly higher in subjects with obesity, dyslipidemia and hypertension compared with those without. In the partial correlation analysis, after controlling for gender, age and creatinine, serum uric acid concentration was significantly positively correlated with BMI (r=0.301, p<0.0001), systolic blood pressure (r=0.151, p<0.0001), diastolic blood pressure (r=0.168, p<0.0001), total cholesterol (r=0.144, p<0.0001) and triacyglycerol (r=0.234, p<0.0001). Results suggest that increased serum uric acid concentration is associated with an increased prevalence of metabolic disorders such as obesity, dyslipidemia and hypertension in the Hangzhou population.
    Asia Pacific Journal of Clinical Nutrition 02/2009; 18(1):81-7. · 1.06 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Uric acid has historically been viewed as a purine metabolic waste product excreted by the kidney and gut that is relatively unimportant other than its penchant to crystallize in joints to cause the disease gout. In recent years, however, there has been the realization that uric acid is not biologically inert but may have a wide range of actions, including being both a pro- and anti-oxidant, a neurostimulant, and an inducer of inflammation and activator of the innate immune response. In this paper, we present the hypothesis that uric acid has a key role in the foraging response associated with starvation and fasting. We further suggest that there is a complex interplay between fructose, uric acid and vitamin C, with fructose and uric acid stimulating the foraging response and vitamin C countering this response. Finally, we suggest that the mutations in ascorbate synthesis and uricase that characterized early primate evolution were likely in response to the need to stimulate the foraging "survival" response and might have inadvertently had a role in accelerating the development of bipedal locomotion and intellectual development. Unfortunately, due to marked changes in the diet, resulting in dramatic increases in fructose- and purine-rich foods, these identical genotypic changes may be largely responsible for the epidemic of obesity, diabetes and cardiovascular disease in today's society.
    Journal of Comparative Physiology B 01/2009; 179(1):67-76. · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the relationship between uric acid (UA) metabolism and fat distribution in 36 obese men with a mean +/- SD age of 38 +/- 16 years and mean body-mass index (BMI) of 34 +/- 4 kg/m2. Subjects were divided into two groups: subcutaneous fat obesity (SFO) and visceral fat obesity (VFO), according to their abdominal fat distribution based on the results of computed tomography (CT). SFO was defined as having a ratio of visceral fat area (VFA) to subcutaneous fat area (V/S) of less than 0.4, and VFO was defined as having a V/S ratio > or = 0.4. The levels of serum total cholesterol (T-Chol), triglyceride (TG), and fasting plasma glucose (FPG), and the diastolic blood pressure (dBP) were significantly higher in the VFO group than in the SFO group. Serum UA levels were much higher in both the SFO and VFO groups than in the non-obese control group (492 +/- 107 and 474 +/- 90 v 309 +/- 48 micromol/L, respectively). The 24-hour urinary urate excretion (u-UA24h) and the UA clearance (Cua) to creatinine clearance (Ccr) ratio were significantly higher in the VFO group than in the SFO group (3.75 +/- 1.43 v 2.69 +/- 1.12 mmol/d, P < .05; and 5.9% +/- 2.0% v 3.6% +/- 1.7%, P < .001, respectively). The frequency of hyperuricemia was markedly higher in both the SFO and VFO groups compared with the control group (71% and 73% v 0%, respectively). Although the high serum UA level seemed to be related to low u-UA24h in 80% of SFO subjects with hyperuricemia, this was the case in only 10% of VFO subjects. While 44% of VFO subjects with hyperuricemia were designated as an overproduction type. These results suggest that the mechanism of hyperuricemia in obesity may be affected by the difference in body fat distribution and that the assessment of body fat distribution and types of hyperuricemia is crucial for the treatment of obese patients with hyperuricemia.
    Metabolism 08/1998; 47(8):929-33. · 3.10 Impact Factor