Procolo Di Bonito1, Giuliana Valerio2, Maria R Licenziati3, Giuseppina Campana3, Emanuele M Del Giudice4, Anna Di Sessa4, Anita Morandi5, Claudio Maffeis5, Claudio Chiesa6, Lucia Pacifico7, Marco G Baroni8, Melania Manco9. 1. Department of Internal Medicine, "S. Maria delle Grazie" Hospital, Pozzuoli, Italy. 2. Department of Movement Sciences and Wellbeing, University "Parthenope", Naples, Italy. 3. Obesity and Endocrine Disease Unit, Department of Neuroscience, Santobono-Pausilipon Children's Hospital, Naples, Italy. 4. Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy. 5. Pediatric Diabetes and Metabolic Disorders Unit, University of Verona, Verona, Italy. 6. Institute of Translational Pharmacology, National Research Council, Rome, Italy. 7. Department of Pediatrics, Policlinico Umberto I Hospital, "Sapienza" University of Rome, Rome, Italy. 8. Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L'Aquila, Italy; IRCCS Neuromed, Pozzilli, IS, Italy. 9. Research Area for Multifactorial Disease and Complex Phenotypes, Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. Electronic address: melania.manco@opbg.net.
Abstract
BACKGROUND AND AIM: The relationships between uric acid (UA) and prediabetes is poorly explored in youth. We investigated the association between UA, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), insulin resistance (IR) and low insulin sensitivity (IS) in youth with overweight/obesity (OW/OB). METHODS AND RESULTS: A cross-sectional study was performed in 2248 youths with OW/OB (age 5-17 years). The sample was stratified in sex-specific quintiles (Q1 to Q5) of UA and the associations with fasting (FG), 2-h post-load glucose (2H-PG), IR and low IS were investigated. IR and low IS were estimated by assessment model of insulin resistance (HOMA-IR) and whole-body IS index (WBISI), respectively. IFG was defined as FG ≥ 100 < 126 mg/dL, IGT as 2H-PG ≥140 < 200 mg/dL, IR as HOMA-IR ≥75th percentile and low IS as WBISI ≤25th percentile by sex. Age, body mass index z-score, 2H-PG, HOMA-IR and WBISI, increased across sex-quintiles of UA while FG did not. The prevalence of IFG and IR were significantly increased in Q5 vs Q1 (reference quartile, P < 0.025). The prevalence of IGT increased from Q3 to Q5 vs Q1 (P < 0.025-0.0001) and that of low IS from Q2 to Q5 vs Q1 (P < 0.005-0.0001). CONCLUSIONS: In youth with OW/OB, rates of IGT and low IS increased progressively across quintiles of UA. On the contrary, IFG and IR were associated only with the highest quintile of UA. Our data suggest that UA is a biomarker of impaired glucose metabolism prevalently in post-challenge condition rather than in fasting state.
BACKGROUND AND AIM: The relationships between uric acid (UA) and prediabetes is poorly explored in youth. We investigated the association between UA, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), insulin resistance (IR) and low insulin sensitivity (IS) in youth with overweight/obesity (OW/OB). METHODS AND RESULTS: A cross-sectional study was performed in 2248 youths with OW/OB (age 5-17 years). The sample was stratified in sex-specific quintiles (Q1 to Q5) of UA and the associations with fasting (FG), 2-h post-load glucose (2H-PG), IR and low IS were investigated. IR and low IS were estimated by assessment model of insulin resistance (HOMA-IR) and whole-body IS index (WBISI), respectively. IFG was defined as FG ≥ 100 < 126 mg/dL, IGT as 2H-PG ≥140 < 200 mg/dL, IR as HOMA-IR ≥75th percentile and low IS as WBISI ≤25th percentile by sex. Age, body mass index z-score, 2H-PG, HOMA-IR and WBISI, increased across sex-quintiles of UA while FG did not. The prevalence of IFG and IR were significantly increased in Q5 vs Q1 (reference quartile, P < 0.025). The prevalence of IGT increased from Q3 to Q5 vs Q1 (P < 0.025-0.0001) and that of low IS from Q2 to Q5 vs Q1 (P < 0.005-0.0001). CONCLUSIONS: In youth with OW/OB, rates of IGT and low IS increased progressively across quintiles of UA. On the contrary, IFG and IR were associated only with the highest quintile of UA. Our data suggest that UA is a biomarker of impaired glucose metabolism prevalently in post-challenge condition rather than in fasting state.
Authors: Maria Francesca Gicchino; Pierluigi Marzuillo; Sarah Zarrilli; Rosa Melone; Stefano Guarino; Emanuele Miraglia Del Giudice; Alma Nunzia Olivieri; Anna Di Sessa Journal: Eur J Pediatr Date: 2022-10-14 Impact factor: 3.860
Authors: Daniel J Cuthbertson; Juha Koskinen; Emily Brown; Costan G Magnussen; Nina Hutri-Kähönen; Matthew Sabin; Päivi Tossavainen; Eero Jokinen; Tomi Laitinen; Jorma Viikari; Olli T Raitakari; Markus Juonala Journal: Ann Med Date: 2021-12 Impact factor: 4.709