Urine excretion of urates in obese children and adolescents affected by Metabolic Syndrome
DOI:
https://doi.org/10.19230/jonnpr.3260Keywords:
Metabolic Syndrome, 24 hours uricosuria, Hyperuricosuria, Urates/Creatinine indexAbstract
Introduction. Disorders of the metabolism of nitrogen bases eventually translating into an increased urine excretionof urates might be present in the Metabolic Syndrome (MS) associated with obesity.
Objectives. To describe the behavior of urates urine excretion in obese children and adolescents diagnosed with MS.
Study design. Analytical, cross-sectional.
Study serie. Fifty-two obese children and adolescents assisted at the Outpatient Clinic of the Endocrinology Service, “Juan Manuel Márquez” Pediatric Teaching Hospital (Havana city, Cuba).
Material and method. Presence of MS in the studied children and adolescents (Boys: 52.0%; Average age: 11.4 ± 3.9 years) was established from the concurrence of augmented abdominal circumference (CA) plus 1 (or more) of any of the followingrisk factors (RF): blood hypertension, Diabetes mellitus, and dyslipidemias. Urates/creatinine (mg/mg) index in urine morning samples was obtained in all cases. rates urine excretion (mg. 24 hours-1) was estimated from the calculated urates/creatinine index after adjusting for sex andheight. 24 hours uricosuria values thus estimated, and hyperuricosuria states (24 hours uricosuria > cutoff point for age), were distributedaccording with MS presence.
Results.Thirty-four-point-six percent of the children presented with one (or more) manifestations of MS. Frequency of hyperuricosuria for the entire serie was 55.8%. Children with MS exhibited higher uricosuria values (? = +56.8 mg. 24 hours-1; p > 0.05) and a greater frequencyof hyperuricosuria (? = +25.2%; p > 0.05). Frequency of hyperuricemia was just 3.8%. Conclusions. MS might be associated with an increasedurates excretion.
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Arroyo-Johnson C, Mincey KD. Obesity epidemiology worldwide. GastroenterolClin 2016;45:571-9.
Swinburn BA, Sacks G, Hall KD, McPherson K, Finegood DT, Moodie ML,Gortmaker SL. The global obesity pandemic: Shaped by global drivers and local environments. Lancet 2011;378(9793):804-14.
Orsi CM, Hale DE, Lynch JL. Pediatric obesity epidemiology. Curr Op Endocrinol DiabObes 2011;18:14-22.
Lo JC, Maring B, Chandra M, Daniels SR, Sinaiko A, Daley MF; et al. Prevalence of obesity and extreme obesity in children aged 3–5years. Pediatr Obes 2014;9:167-75.
Hruby A, Hu FB. The epidemiology of obesity: A big picture. Pharmacoeconomics 2015;33:673-89.
Cunningham SA, Kramer MR, Narayan KV. Incidence of childhood obesity in the United States. N EnglJMed 2014;370:403-11.
Berghöfer A, Pischon T, Reinhold T, Apovian CM, Sharma AM, Willich SN. Obesity prevalence from a European perspective: A systematic review. BMC Public Health2008; 8(1):200-200. Disponible en: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-8-200. Fecha de última visita: 6 de Mayo del 2019.
Cattaneo A, Monasta L, Stamatakis E, Lioret S, Castetbon K, Frenken F; et al. Overweight and obesity in infants and pre-school children in the European Union: A review of existing data. Obes Rev 2010;11:389-98.
Filozof C, Gonzalez C, Sereday M, Mazza C, Braguinsky J. Obesity prevalence and trends in Latin-American countries. Obes Rev 2001;2:99-106.
Rivera JÁ, de Cossío TG, Pedraza LS, Aburto TC, Sánchez TG, Martorell R. Childhood and adolescent overweight and obesity in Latin America: A systematic review. The Lancet Diab Endocrinol 2014;2:321-32.
Acosta Jiménez SM, Rodríguez Suárez A, Díaz Sánchez ME. La obesidad en Cuba. Una mirada a su evolución en diferentes grupos poblacionales. RCAN Rev Cubana Aliment Nutr 2013;23:297-308.
Engin A. The definition and prevalence of obesity and Metabolic syndrome. Adv Exp Med Biol 2017;960:1-17. Disponible en: http://doi:10.1007/978-3-319-48382-5_1. Fecha de última visita: 9 de Mayo del 2019.
Haffner S, Taegtmeyer H. Epidemic obesity and the metabolic syndrome. Circulation 2003;108:1541-5.
Puig JG, Martinez MA. Hyperuricemia, gout and the metabolic syndrome. Curr OpRheumatol 2008;20:187-91.
Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am JMed 2007;120:442-7.
Yamanaka H. Gout and hyperuricemia in young people. Curr OpRheumatol 2011;23:156-60.
Nakagawa T, Cirillo P, Sato W, Gersch M, Sautin Y, Roncal C; et al. The conundrum of hyperuricemia, metabolic syndrome, and renal disease. Intern Emerg Med 2008;3:313-8.
Abate N, Chandalia M, Cabo-Chan AV, Moe OW, Sakhaee K. The metabolic syndrome and uric acid nephrolithiasis: Novel features of renal manifestation of insulin resistance. Kidney International 2004;65:386-92.
Chou YH, Su CM, Li CC, Liu CC, Liu ME, Wu WJ, Juan YS. Difference in urinary stone components between obese and non-obese patients. Urol Res 2011;39:283-7.
Li WM, Chou YH, Li CC, Liu CC, Huang SP, Wu WJ; et al. Association of body mass index and urine pH in patients with urolithiasis. Urol Res 2009;37:193-193. Disponible en: https://doi.org/10.1007/s00240-009-0194-4. Fecha de última visita: 10 de Mayo del 2019.
Caleffi A, Manoni F, Alessio MG, Ottomano C, Lippi G. Quality in extra-analytical phases of urinanalysis. Biochem Med [Zagreb] 2010;20:179-83.
Tormo C, Lumbreras B, Santos A, Romero L, Conca M. Strategies for improving the collection of 24-hour urine for analysis in the clinical laboratory: redesigned instructions, opinion surveys, and application of reference change value to micturition. Arch Pathol Lab Med 2009;133:1954-60.
Turner WJ, Merlis S. Vicissitudes in research: The twenty-four hour urine collection. Clin PharmacolTher 1971;12(2 Part1):163-6.
Miler M, Simundić AM. Low level of adherence to instructions for 24-hour urine collection among hospital outpatients. Biochem Med [Zagreb] 2013;23:316-20.
Salabarría González JR, Santana Porbén S, Liriano Ricabal MR. Excreción urinaria de una sustancia predicha del índice sustancia-creatinina. Rev LatinoamPatolClínMedLab 2015;62:119-26. Disponible en: https://www.medigraphic.com/cgibin/new/resumen.cgi?IDARTICULO=58177. Fecha de última visita: 10 de Mayo del 2019.
Onis M; for the WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards based on length/height, weight and age. ActaPaediatr 2006;95:76-85.
Onis MD, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull WorldHealthOrg 2007;85:660-7.
Callaway CW, Chumlea WC, Bouchard C, Himes JH, Lohman TG, Martin AD;et al.Circumferences. En: Anthropometric standardization reference manual [Editores: Lohman TG, Roche AF, Martorell R].Human KineticsBooks. Champaign [Illinois]: 1991. Pp. 44-55.
Berdasco A, Esquivel M, Jiménez JM, Mesa D, Posada E, Romero JM; et al. Segundo estudio nacional de crecimiento y desarrollo, Cuba 1982: valores de peso y talla para la edad. Rev Cubana Pediatr 1991;63:4-21.
World Health Organization. WHO child growth standards: Length/height for age, weightfor- age, weight-for- length, weight-for-height and body mass index-for-age, methods and development. Geneva: 2006. Disponible en:https://apps.who.int/iris/bitstream/handle/10665/43413/924154693X_eng.pdf. Fecha de última visita: 10 de Mayo del 2019.
Esquivel Lauzurique M. Valores cubanos del índice de masa corporal en niños y adolescentes de 0 a 19 años. Rev CubanaPediatr 1991;63:181-90.
Esquivel Lauzurique M, Rubén Quesada M, González Fernández C, Rodríguez Chávez L, Tamayo Pérez V. Curvas de crecimiento de la circunferencia de la cintura en niños y adolescentes habaneros. Rev Cubana Pediatr 2011;83:44-55. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312011000100005&lng=es. Fecha de última visita: 13 de Diciembre del 2018.
Maffeis C, Banzato C, Talamini G; for the Italian Obesity Study Group. Waist-to-height ratio, a useful index to identify high metabolic risk in overweight children.JPediatr 2008;152:207-13.
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN; et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: Blood pressure measurement in humans: A statement for professionals from the Subcommittee of Professional and Public Education of the American Heart
Association Council on High Blood Pressure Research. Circulation 2005;111:697-716.
National High Blood Pressure Education Program Working Group. Update on the Task Force (1987) on high blood pressure in children and adolescents. Pediatrics 1996;98:649-58.
Falkner B, Daniels SR. Summary of the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Hypertension [Dallas] 2004;44:387-8.
Zimmet P, Alberti KGM, Kaufman F, Tajima N, Silink M, Arslanian S; for the IDF Consensus Group. The metabolic syndrome in children and adolescents– An IDF consensus report. Pediatric Diabetes 2007;8:299-306.
Passwell JH, Modan M, Brish M, Orda S, Boichis H. Fractional excretion of uric acid in infancy and childhood: Index of tubular maturation. Arch Dis Child 1974;49:878-82.
Stapleton FB, Linshaw MA, Hassanein K, Gruskin AB. Uric acid excretion in normal children.JPediatr 1978;92:911-4.
Santana Porbén S, Martínez Canalejo H. Manual de Procedimientos Bioestadísticos. Segunda Edición. EAE Editorial Académica Española. ISBN-13: 9783659059629. ISBN-10: 3659059625. Madrid: 2012.
Salabarría, J.S.; Santana, S.; Martinez, H; Benitez, L.M.: Intervalos de predicción como valores de referencia para la creatinina sérica en una población infantil. Bol. Med Hosp Infant Méx 1997;54:115-23.
Monteagudo Rodríguez Y, Santana Porbén S, Salabarría González JR. Intervalos locales de referencia para la excreción urinaria de creatinina en niños y adolescentes cubanos. Rev Cubana AlimentNutr 2015;25(Supl 1):S59- S90.
Kim SS, Luan X, Canning DA, Landis JR, Keren R. Association between body mass index and urolithiasis in children.JUrol 2011;186:1734-39.
Eisner BH, Eisenberg ML, Stoller ML. Influence of body mass index on quantitative 24- hour urine chemistry studies in children with nephrolithiasis. JUrol 2009;182:1142-5.
Oquendo de la Cruz Y, Piñeiro Lamas R, Duarte MC, Guillen Dosal A. Síndrome metabólico en niños y adolescentes hipertensos obesos. Rev Cubana Pediatr 2010;82(4):31-40.Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-75312010000400004&lng=es. Fecha de última visita: 11 de Mayo del 2019.
La Manna A, Polito C, Marte A, Iovene A, Di Toro R. Hyperuricosuria in children: Clinical presentation and natural history. Pediatrics 2001;107:86-90.
Praga M, Alegre R, Hernández E, Morales E, Domínguez-Gil B, Carreño A, Andrés A. Familialmicroscopic hematuria causedbyhypercalciuria and hyperuricosuria. Am JKid Dis 2000;35:141-5.
Polito C, La Manna A, Napp B, Villani J, Di Toro R. Idiopathic hypercalciuria and hyperuricosuria: Family prevalence of nephrolithiasis. Pediatr Nephrol 2000;14:1102-4.
Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD. Temporal trends in incidence of kidney stones among children: A 25-year population based study. JUrol 2012;188:247-52.
Matlaga BR, Schaeffer AJ, Novak TE, Trock BJ. Epidemiologic insights into pediatric kidney stone disease. Urol Res 2010;38(6):453-57.Disponible en: https://rd.springer.com/article/10.1007/s00240-010-0327-9. Fecha de última visita: 12 de Mayo del 219.
Clifford AJ, Riumallo JA, Young VR, Scrimshaw NS. Effect of oral purines on serum and urinary uric acid of normal, hyperuricemic and gouty humans. J Nutr 1976;106(3):428-34.Disponible en:https://academic.oup.com/jn/article-abstract/106/3/428/4763582. Fecha de última visita: 13 de Mayo del 2019.
Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men.NEngl J Med 2004;350:1093-103.
Nakagawa T, Tuttle KR, Short RA, Johnson RJ. Hypothesis: Fructose-induced hyperuricemia as a causal mechanism for the epidemic of the metabolic syndrome. Nature Clin PractNephrol 2005;1:80-6.
Johnson RJ, Nakagawa T, Sanchez-Lozada LG, Shafiu M, Sundaram S, Le M;et al. Sugar, uric acid, and the etiology of diabetes and obesity. Diabetes 2013;62:3307-15.
Shavit L, Ferraro PM, Johri N, Robertson W, Walsh SB, Moochhala S, Unwin R. Effect of being overweight on urinary metabolic risk factors for kidney stone formation.Nephrol Dial Transplant 2015;30:607-13.
Bobulescu IA, Moe OW. Renal transport of uric acid: Evolving concepts and uncertainties. Adv Chronic Kidney Dis 2012;19:358-71.
Hediger MA, Johnson RJ, Miyazaki H, Endou H. Molecular physiology of uratetransport. Physiology 2005;20:125-33.
Facchini F, Chen YDI, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA 1991;266:3008-11.
Cameron MA, Maalouf NM, Adams-Huet B, Moe OW, Sakhaee K. Urinecomposition in type 2 diabetes: Predisposition to uric acid nephrolithiasis. J Am SocNephrol 2006;17:1422-8.
Goodpaster BH, Wolf D. Skeletal muscle lipid accumulation in obesity, insulin resistance, and type 2 diabetes. Pediatr Diab 2004;5:219-26.
Santana Porbén S, Salabarría González JR, LirianoRicabal, MR.Excreción urinaria de una sustancia predicha de la densidad urinaria. Revista LatinoamPatolClínMedLab 2015;62(3): 163-73. Disponible en:https://www.medigraphic.com/cgibin/new/resumen.cgi?IDARTICULO=59469. Fecha de última visita: 16 de Mayo del 2019.
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