title: The effect of a one-year weight reduction program on serum uric acid in overweight/obese children and adolescents.
abstract: BACKGROUND
  Hyperuricemia may underlie obesity and related disorders, but the impact of weight reduction and metformin on serum uric acid (sUA) in Caucasian children/adolescents is unknown.
  
  
  METHODS
  One hundred and thirteen children/adolescents were enrolled (83 completed) into 1-year weight reduction program (diet+exercise) without or with metformin. Anthropometric and biochemical measurements were conducted at baseline and at the end of follow-up (13 ± 3 months).
  
  
  RESULTS
  sUA decreased in 86% females and 67% males. Significantly more patients substantially (≥ 10%) reduced their sUA than body mass index (BMI)%. In females, sUA decreased regardless of type of intervention, but more markedly in the metformin group, and ΔsUA correlated positively with ΔBMI%, ΔWHtR (waist-to-height ratio), Δinsulin, ΔHOMA (homeostasis model of assessment), and Δtriglycerides/high density lipoprotein (HDL), but correlated negatively with baseline sUA, HOMA, insulin, and triglycerides/HDL. Of these, metformin treatment, baseline sUA, and ΔBMI% were independent predictors of sUA reduction, explaining 77% of data variability. In males, sUA reduction was significant in the metformin group only, and negatively correlated with ΔWHR (waist-to-hip ratio), ΔWHtR, Δleptin, baseline sUA, and waist circumference. Of these, baseline sUA and ΔBMI% were independent predictors of sUA reduction, explaining 69% of data variability. Except for sUA, females reduced their BMI%, waist circumference, triglycerides, triglycerides/HDL and increased HDL, while males reduced total cholesterol.
  
  
  CONCLUSIONS
  A longitudinal weight reduction program encompassing diet/exercise with or without metformin was more efficient in reducing sUA than weight and its effect on sUA and other metabolic parameters differed between genders. Weight loss did not condition sUA reduction, which was strongly dependent on baseline levels. The sUA reducing effects of metformin may contribute to its effects on blood pressure-lowering and endothelial function-improving properties in females.
authors.affiliation: Department of Medical Biochemistry, Wroclaw Medical University, Wroclaw, Poland. krzystek@bioch.am.wroc.pl
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Krzystek-Korpacka
authors.forename: Eliza
authors.initials: E
authors.lastname: Patryn
authors.forename: Irena
authors.initials: I
authors.lastname: Kustrzeba-Wojcicka
authors.forename: Joanna
authors.initials: J
authors.lastname: Chrzanowska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Gamian
authors.forename: Anna
authors.initials: A
authors.lastname: Noczynska
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D004032:Diet; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use; D009765:Obesity / Q000097:blood* / Q000178:diet therapy / Q000188:drug therapy / Q000503:physiopathology*; D012737:Sex Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood*; D015431:Weight Loss / Q000187:drug effects
chemical_list: D014527:Uric Acid; D008687:Metformin