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Metabolik sendromlu obez hastalarda serum ürik asit düzeyleri

Year 2021, Volume: 46 Issue: 1, 108 - 115, 31.03.2021

Abstract

Amaç: Bu çalışmada; obez hastalarda metabolik sendrom görülme sıklığının belirlenmesi ve metabolik sendromlu obez hastalarda serum ürik asit düzeylerinin değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Retrospektif çalışmaya Kasım 2018-Şubat 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi Obezite Merkezinde takipli 270 obez hasta dahil edildi. Metabolik sendrom olan ve olmayan şeklinde iki gruba ayrılan hastalar serum ürik asit düzeyleri ve diğer çalışma parametreleri açısından karşılaştırıldı.
Bulgular: Hastaların %92,6’sı kadın, %7,4'ü erkekti. Ortalama yaş 51,8±9,6 (21–73) yıl idi. 141 hastada (%52,22) metabolik sendrom vardı. Metabolik sendrom olan hastalarda kilo, vücut kitle indeksi, bel/kalça oranı ölçümleri anlamlı yüksek bulundu. Metabolik sendrom parametrelerinin yanı sıra glikozillenmiş hemoglobin, açlık insülini, insülin direnci ve ürik asit düzeyleri de metabolik sendrom olan grupta anlamlı yüksekti. Metabolik sendrom olan hastalarda ürik asit ile bel çevresi, açlık insülini ve insülin direnci arasında istatistiksel olarak anlamlı pozitif bir korelasyon saptandı. Çok değişkenli lojistik regresyon analizi; ürik asitin diğer parametrelerden bağımsız olarak metabolik sendrom riskini arttırdığını gösterdi.
Sonuç: Obez hastalarda metabolik sendrom görülme sıklığı artmaktadır ve metabolik sendromun eşlik ettiği obez hastalarda serum ürik asit düzeyleri yükselmektedir. Ayrıca bu hastalarda serum ürik asit düzeyleri ile bel çevresi ve insülin direnci arasında pozitif korelasyon görülmektedir. Bu bağlamda, özellikle abdominal obezite ve insülin direnci tespit edilen metabolik sendromlu obez hastalar kardiyovasküler hastalık risk belirteci olarak değerlendirilen hiperürisemi açısından taranmalıdır.

Thanks

Bu çalışmanın istatistiksel analiz sürecinde verdiği tüm desteklerden dolayı Başak OĞUZ YOLCULAR’a teşekkürlerimi sunarım.

References

  • 1. TEMD Obezite, Lipid Metabolizması, Hipertansiyon Çalışma Grubu. Obezite Tanı ve Tedavi Kılavuzu 2019, 8. baskı. Ankara, Türkiye Endokrinoloji ve Metabolizma Derneği, 2019.
  • 2. Kim SK. Interrelationship of uric acid, gout, and metabolic syndrome: Focus on hypertension, cardiovascular disease, and insulin resistance. J Rheum Dis 2018;25:19-27.
  • 3. Liberopoulos EN, Mikhailidis DP, Elisaf MS. Diagnosis and management of the metabolic syndrome in obesity. Obes Rev 2005;6:283-96.
  • 4. Balkan F. Metabolik sendrom. Ankara Medical Journal 2013;13:85-90.
  • 5. Aguilar-Salinas CA, Viveros-Ruiz T. Recent advances in managing/understanding the metabolic syndrome. F1000Res 2019;8:370-9.
  • 6. Akbaş EM, Özçiçek A, Özçiçek F, Demirtaş L, Timuroğlu A, Güngör A, Akbaş N. Metabolik olarak sağlıklı ve sağlıksız obez hastalarda ürik asit seviyeleri. Dicle Tıp Dergisi 2014;41:676-80.
  • 7. Ayyıldız SN. Ürik asit yüksekliğinin analizi. JAREM 2016;6:74-7.
  • 8. Choi HK, McCormick N, Lu N, Rai SK, Yokose C, Zhang Y. Population Impact Attributable to Modifiable Risk Factors for Hyperuricemia. Arthritis Rheumatol 2020;72:157-65.
  • 9. Kayhan Tetik B, Baydar Artantaş A, İnce B, Üstü Y. Üçüncü atakta tanı konulan bir gut vakası. Ankara Medical Journal 2012;12(2):100-2.
  • 10. Ali N, Perveen R, Rahmen S, Mahmood S, Rahman S, Islam S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults. PLoS One 2018;13(11): e0206850.
  • 11. Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuricemia: a reality in the Indian obese. Obesity Surgery 2012;22(6):945-8.
  • 12. Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension 2006;48(6):1031-6.
  • 13. Huda N, Hossain S, Rahman M, Karim MR, Islam K, Mamun AA, et al. Elevated levels of plasma uric acid and its relation to hypertension in arsenic-endemic human individuals in Bangladesh. Toxicol Appl Pharmacol 2014;281(1):11-8.
  • 14. Desai RJ, Franklin JM, Spoendlin-Allen J, Solomon DH, Danaei G, Kim SC. An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout. PLoS One 2018;13(2):e0193622.
  • 15. Wang H, Zhang H, Sun L, Guo W. Roles of hyperuricemia in metabolic syndrome and cardiac-kidney-vascular system diseases. Am J Transl Res 2018;10(9):2749-63.
  • 16. Pereira SS, Alvarez Leite-JI. Low-Grade Inflammation, obesity, and diabetes. Curr Obes Rep 2014;3(4):422-31.
  • 17. Cooke AA, Connaughton RM, Lyons CL, McMorrow AM, Roche HM. Fatty acids and chronic low grade inflammation associated with obesity and the metabolic syndrome. Eur J Pharmacol 2016;785:207-14.
  • 18. Zhou Y, Zhao M, Pu Z, Xu G, Li X. Relationship between oxidative stress and inflammation in hyperuricemia. Medicine (Baltimore) 2018;97(49):e13108.
  • 19. Solak B, Sevimli Dikicier B, Erdem T. Metabolik sendromlu psoriazis hastalarında ürik asitin rolü. Turk Arch Dermatol Venereology 2017;51:37-40.
  • 20. Suliga E, Koziel D, Gluszek S. Prevalence of metabolic syndrome in normal weight individuals. Ann Agric Environ Med 2016;23(4):631-35.
  • 21. Duan Y, Liang W, Zhu L, Zhang T, Wang L, Nie Z, et al. Association between serum uric acid levels and obesity among university students. Nutr Hosp 2015;31(6):2407-11.
  • 22. Mukhopadhyay P, Ghosh S, Pandit K, Chatterjee P, Majhi B, Subhankar ChowdhuryS. Uric acid and its correlation with various metabolic parameters: A population-based study. Indian J Endocrinol Metab 2019;23(1):134-9.
  • 23. Li L, Song Q, Yang X. Lack of associations between elevated serum uric acid and components of metabolic syndrome such as hypertension, dyslipidemia, and T2 DM in overweight and obese Chinese adults. Journal of Diabetes Research 2019(11):1-8.
  • 24. Kim IY, Han KD, Kim DH, Eun Y, Cha HS, Koh EM, et al. Women with metabolic syndrome and general obesity are at a higher risk for significant hyperuricemia compared to men. J Clin Med 2019;8(6):837.
  • 25. Chen LY, Zhu WH, Chen ZW, Dai HL, Ren JJ, Chen JH, et al. Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B 2007;8(8):593-8.
  • 26. Lee WS, Kang TS, Lee YH, Han MK. Assessment of association between metabolic syndrome and serum uric acid level in subjects who visited the health promotion center. Korean J Fam Pract 2017;7(2):207-12.

Serum uric acid levels in obese patients with metabolic syndrome

Year 2021, Volume: 46 Issue: 1, 108 - 115, 31.03.2021

Abstract

Purpose: The aim of this study was to determine the frequency of metabolic syndrome in obese patients and to evaluate serum uric acid levels in obese patients with metabolic syndrome.
Materials and Methods: The retrospective study included 270 obese patients with follow-up at the Obesity Center of Health Sciences University Antalya Training and Research Hospital between November 2018 and February 2020. Patients who were divided into two groups with and without metabolic syndrome were compared in terms of serum uric acid levels.
Results: Of the patients 92,6% were female and 7,4% were male. The average age was 51,8±9,6 years. 141 patients (52,22%) had metabolic syndrome. Weight, body mass indexe, waist/hip ratio were significantly higher in patients with metabolic syndrome. In addition to metabolic syndrome parameters, glycosylated hemoglobin, fasting insulin, insulin resistance and uric acid levels were also significantly higher in the group with metabolic syndrome. A statistically significant positive correlation was found between uric acid and waist circumference, fasting insulin and insulin resistance in patients with metabolic syndrome. Multivariate logistic regression analysis showed that uric acid increased the risk of metabolic syndrome regardless of other parameters.
Conclusion: The frequency of metabolic syndrome increases in obese patients, and serum uric acid levels increase in obese patients accompanied by metabolic syndrome. In addition, there is a positive correlation between serum uric acid levels and waist circumference and insulin resistance in these patients. Especially obese patients with metabolic syndrome accompanying with abdominal obesity and insülin resistance should be screened for hyperuricemia, which is considered as a cardiovascular disease risk marker.

References

  • 1. TEMD Obezite, Lipid Metabolizması, Hipertansiyon Çalışma Grubu. Obezite Tanı ve Tedavi Kılavuzu 2019, 8. baskı. Ankara, Türkiye Endokrinoloji ve Metabolizma Derneği, 2019.
  • 2. Kim SK. Interrelationship of uric acid, gout, and metabolic syndrome: Focus on hypertension, cardiovascular disease, and insulin resistance. J Rheum Dis 2018;25:19-27.
  • 3. Liberopoulos EN, Mikhailidis DP, Elisaf MS. Diagnosis and management of the metabolic syndrome in obesity. Obes Rev 2005;6:283-96.
  • 4. Balkan F. Metabolik sendrom. Ankara Medical Journal 2013;13:85-90.
  • 5. Aguilar-Salinas CA, Viveros-Ruiz T. Recent advances in managing/understanding the metabolic syndrome. F1000Res 2019;8:370-9.
  • 6. Akbaş EM, Özçiçek A, Özçiçek F, Demirtaş L, Timuroğlu A, Güngör A, Akbaş N. Metabolik olarak sağlıklı ve sağlıksız obez hastalarda ürik asit seviyeleri. Dicle Tıp Dergisi 2014;41:676-80.
  • 7. Ayyıldız SN. Ürik asit yüksekliğinin analizi. JAREM 2016;6:74-7.
  • 8. Choi HK, McCormick N, Lu N, Rai SK, Yokose C, Zhang Y. Population Impact Attributable to Modifiable Risk Factors for Hyperuricemia. Arthritis Rheumatol 2020;72:157-65.
  • 9. Kayhan Tetik B, Baydar Artantaş A, İnce B, Üstü Y. Üçüncü atakta tanı konulan bir gut vakası. Ankara Medical Journal 2012;12(2):100-2.
  • 10. Ali N, Perveen R, Rahmen S, Mahmood S, Rahman S, Islam S, et al. Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults. PLoS One 2018;13(11): e0206850.
  • 11. Remedios C, Shah M, Bhasker AG, Lakdawala M. Hyperuricemia: a reality in the Indian obese. Obesity Surgery 2012;22(6):945-8.
  • 12. Perlstein TS, Gumieniak O, Williams GH, Sparrow D, Vokonas PS, Gaziano M, et al. Uric acid and the development of hypertension: the normative aging study. Hypertension 2006;48(6):1031-6.
  • 13. Huda N, Hossain S, Rahman M, Karim MR, Islam K, Mamun AA, et al. Elevated levels of plasma uric acid and its relation to hypertension in arsenic-endemic human individuals in Bangladesh. Toxicol Appl Pharmacol 2014;281(1):11-8.
  • 14. Desai RJ, Franklin JM, Spoendlin-Allen J, Solomon DH, Danaei G, Kim SC. An evaluation of longitudinal changes in serum uric acid levels and associated risk of cardio-metabolic events and renal function decline in gout. PLoS One 2018;13(2):e0193622.
  • 15. Wang H, Zhang H, Sun L, Guo W. Roles of hyperuricemia in metabolic syndrome and cardiac-kidney-vascular system diseases. Am J Transl Res 2018;10(9):2749-63.
  • 16. Pereira SS, Alvarez Leite-JI. Low-Grade Inflammation, obesity, and diabetes. Curr Obes Rep 2014;3(4):422-31.
  • 17. Cooke AA, Connaughton RM, Lyons CL, McMorrow AM, Roche HM. Fatty acids and chronic low grade inflammation associated with obesity and the metabolic syndrome. Eur J Pharmacol 2016;785:207-14.
  • 18. Zhou Y, Zhao M, Pu Z, Xu G, Li X. Relationship between oxidative stress and inflammation in hyperuricemia. Medicine (Baltimore) 2018;97(49):e13108.
  • 19. Solak B, Sevimli Dikicier B, Erdem T. Metabolik sendromlu psoriazis hastalarında ürik asitin rolü. Turk Arch Dermatol Venereology 2017;51:37-40.
  • 20. Suliga E, Koziel D, Gluszek S. Prevalence of metabolic syndrome in normal weight individuals. Ann Agric Environ Med 2016;23(4):631-35.
  • 21. Duan Y, Liang W, Zhu L, Zhang T, Wang L, Nie Z, et al. Association between serum uric acid levels and obesity among university students. Nutr Hosp 2015;31(6):2407-11.
  • 22. Mukhopadhyay P, Ghosh S, Pandit K, Chatterjee P, Majhi B, Subhankar ChowdhuryS. Uric acid and its correlation with various metabolic parameters: A population-based study. Indian J Endocrinol Metab 2019;23(1):134-9.
  • 23. Li L, Song Q, Yang X. Lack of associations between elevated serum uric acid and components of metabolic syndrome such as hypertension, dyslipidemia, and T2 DM in overweight and obese Chinese adults. Journal of Diabetes Research 2019(11):1-8.
  • 24. Kim IY, Han KD, Kim DH, Eun Y, Cha HS, Koh EM, et al. Women with metabolic syndrome and general obesity are at a higher risk for significant hyperuricemia compared to men. J Clin Med 2019;8(6):837.
  • 25. Chen LY, Zhu WH, Chen ZW, Dai HL, Ren JJ, Chen JH, et al. Relationship between hyperuricemia and metabolic syndrome. J Zhejiang Univ Sci B 2007;8(8):593-8.
  • 26. Lee WS, Kang TS, Lee YH, Han MK. Assessment of association between metabolic syndrome and serum uric acid level in subjects who visited the health promotion center. Korean J Fam Pract 2017;7(2):207-12.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Research
Authors

Remziye Nur Eke 0000-0002-2410-0802

Publication Date March 31, 2021
Acceptance Date October 12, 2020
Published in Issue Year 2021 Volume: 46 Issue: 1

Cite

MLA Nur Eke, Remziye. “Metabolik Sendromlu Obez Hastalarda Serum ürik Asit düzeyleri”. Cukurova Medical Journal, vol. 46, no. 1, 2021, pp. 108-15.