Name: STEPHANIE REZENDE ALVARENGA MOULIN MARES
Publication date: 06/03/2020
Advisor:
Name |
Role |
|---|---|
| JOSE GERALDO MILL | Advisor * |
Examining board:
| Name |
Role |
|---|---|
| CARMEM LUIZA SARTORIO | Internal Examiner * |
| DALTON VALENTIM VASSALLO | Internal Examiner * |
| JOSE GERALDO MILL | Advisor * |
| MARCELO PERIM BALDO | External Examiner * |
| VALÉRIA VALIM CRISTO | External Examiner * |
Summary: BACKGROUND: Hyperuricemia in adults is associated with cardiovascular diseases.
However, there is lack of information regarding serum uric acid (SUA) determinants in
children and adolescents. Our purpose was to determine the SUA distribution in
schoolchildren and the possible association between increased SUA levels and
cardiovascular risk factors. METHODS: A fasting blood sample was collected from
1.750 children and adolescents (6-18 years, 56% boys) enrolled in institution called
Estação Conhecimento, Serra/ES, Brazil. Internal cut-offs were generated to define
hyperuricemia (≥90th percentile of SUA concentration for sex and age group). Puberty
was defined according to Tanner scale. Body weight and fat mass was determined
with a bioimpedance scale. Data are given as mean ± standard deviation. RESULTS:
The degree of puberty, age and sex influence the distribution of AUS, and the average
of AUS was higher among individuals who had already entered puberty (4.2 ± 1.1
mg/dL) than in the prepubescent ones. (3.6 ± 0.8 mg/dL; p <0.001), with a greater
difference between male pubertal (4.4 ± 1.2 mg / dL) compared to females (4.0 ± 1.0
mg / dL; p <0.001). The following uric acid reference values (p90 for sex and age
group) was proposed: under 10 years: ≤ 4.8 mg/dL; from 10 to 13 years: ≤ 5.7 mg/dL
in boys ≤ 5.2 mg/dL in girls; and 14 to 17 years: ≤ 6.4 mg/dL in boys ≤ 5.3 mg/dL in
girls. Hyperuricemia was associated with overweight/obesity (OR 3.5 CI 95% 2.6-4.8),
high waist circumference (OR 3.7 CI 95% 2.7-5.1), dyslipidemia (OR 2.8 95% CI 1.9-
4.1), high blood pressure (OR 1.9 95% CI 1.1-3.3), high fat percentage (8,7% vs.
21,1% - OR 2.8 IC 95% 1.9-4.1), metabolic syndrome (OR 3.3 95% CI 1.6-6.7) and
hyperinsulinemia (OR 2.0 95% CI 1.3-3.1). Individuals in the fourth quartile of AUS
compared to those in the first quartile had higher age, pIMC, waist circumference,
percentage of fat and lean mass. Using a reference value of 5.5mg/dL, the prevalence
of hyperuricemia in children and adolescents was 10.3% of the sample. Lean mass
was the main variable independently associated with higher AUS values.
CONCLUSION: Higher AUS values are associated with higher cardiovascular risk in
childhood and adolescence. The main cardiovascular risk factors associated with
hyperuricemia in this population were overweight/obesity, high waist circumference,
dyslipidemia, high fat percentage, high blood pressure, hyperinsulinemia and
metabolic syndrome.
