Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: Visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity

doi:10.1016/S0026-0495(98)90346-8

Metabolism

Volume 47, Issue 8, August 1998, Pages 929-933

https://doi.org/10.1016/S0026-0495(98)90346-8 Get rights and content

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 distribtion 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 ≥ 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 μmol/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 designed 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.

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Hyperuricemia has become a vital public health problem affecting the health of residents. The visceral fat area (VFA) is closely related to many chronic diseases. However, the association between VFA and hyperuricemia within the Chinese adult population remains nebulous. The aim of the research is to assess the relationship between VFA and serum uric acid levels.
From June 2020 to June 2021, a total of 340 Chinese adults (240 in the control group and 100 in the hyperuricemia group) were recruited from the physical examination center of Hongqi Hospital Affiliated to Mudanjiang Medical University. General demographic characteristics were collected by questionnaire. VFA was measured by a body composition analyzer, and serum biochemical indices were detected by clinical laboratory. VFA in the hyperuricemia group was higher than in the control group (P＜0.05). Further, VFA demonstrated a positive correlation with serum uric acid level (r_s = 0.370, P＜0.001). To further explore this relationship, we divided the VFA into quartiles (＜P₂₅, P₂₅–P₅₀, P₅₀–P₇₅, ≥P₇₅). Upon comparison with the ＜P₂₅ group, we found the VFA in the P₂₅–P₅₀, P₅₀–P₇₅, and ≥P₇₅ groups to be associated with a substantially escalated risk of hyperuricemia, even after adjusting for age, gender, body weight, fasting plasma glucose, calcium, alanine transaminase, urea, alkaline phosphatase, and γ-glutamyltransferase. The OR and 95% CI were 2.547 (1.023, 6.341), 3.788 (1.409, 10.187) and 3.723 (1.308, 10.595), respectively (P＜0.05).
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The visceral adiposity index (VAI), a gender-specific surrogate maker of adipose tissue distribution and function, is associated with risk of hyperuricemia. However, the impact of time-burden of abnormal VAI and its components on the risk of hyperuricemia remains unknown.
We included 56,537 participants without hyperuricemia and underwent two health examinations during 2006–2008 from the Kailuan study. Abnormal VAI burdens were evaluated as follows: (1) cumulative number of abnormal VAI presented at each examination (0–2 times); (2) cumulative number of each abnormal VAI component presented at each examination (0–2 times per component); (3) cumulative number of total abnormal VAI components presented at each examination (0–8 times).
During a median follow-up of 8.81 years, 10,762 participants were diagnosed with hyperuricemia. The risk of hyperuricemia showed a positive association with cumulative number of abnormal VAI, the adjusted hazard ratio (HR) with 95% confidence interval (CI) of 2 times compared to 0 times was 1.69 (1.58–1.81). All four components of abnormal VAI, when diagnosed repeatedly, were independently associated with an increased risk of hyperuricemia, adjusted HR (95% CI) from 1.15 (1.02–1.28) for low high-density lipoprotein to 1.68 (1.58–1.79) for elevated triglyceride. The risk of hyperuricemia also gradually as abnormal components was accumulated from 0 to 8 counts, reaching an adjusted HR (95% CI) of 3.72 (2.64–5.23). Furthermore, the effect of cumulative abnormal VAI was more pronounced in females than males (P-interaction < 0.0001).
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^☆: Supported by a Grant No. 07671132 from the Ministry of Education, Science, Sports, and Culture of Japan, and by a grant from the Uehara Memorial Foundation, 1996.

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Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: Visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity☆

Abstract

Am J Clin Nutr

Metabolism

Am J Cardiol

J Chronic Dis

Atherosclerosis

Metabolism

Metabolism

Metabolism

Metabolism

Serum uric acid in relation to body weight

Ann Rheum

Alteration of urate metabolism by weight reduction

Aust NZ J Med

The effect of weight loss on plasma and urinary uric acid and lipid level

Adv Exp Med Biol

Studies on the impaired metabolism of uric acid in obese subjects: Marked reduction of renal urate excretion and its improvement by a low-calorie diet

Int J Obes

A novel technique for the determination of body fat by computed tomography

Int J Obes

Close correlation of intraabdominal fat accumulation to hypertension in obese women

Hypertension

Über den Niederschlag, Welchen Pikrinsäure innormalem Harnerzeugt und über eine neue Reaktion des Kleatinins

Hoppe Seyler Z Physiol Chem