title: ESR1 gene and insulin resistance remission are associated with serum uric acid decline for severely obese patients undergoing bariatric surgery.
abstract: BACKGROUND
  Hyperuricemia is associated with obesity. Few studies have reported the effects of different types of bariatric surgery on uric acid metabolism. The aim of our study was to determine the relationships between serum uric acid reduction and estrogen receptor-α (ESR1) gene polymorphism, as well as the type of bariatric surgery received. The potential physiological pathways involved in postsurgery serum uric acid reduction were also discussed.
  
  
  METHODS
  A total of 508 severely obese Han Chinese patients, aged 20 to 50 years, with a body mass index (BMI)≥35 kg/m(2) were selected. Patients received either laparoscopic adjustable gastric banding (LAGB; n = 164) or laparoscopic mini-gastric bypass (LMGB; n = 344). A 12-month follow-up was performed to explore the effects of the type of bariatric surgery and ESR1 polymorphism on serum uric acid reduction.
  
  
  RESULTS
  The rs712221 polymorphism of ESR1 affects serum uric acid reduction after bariatric surgery. The LMGB group exhibited a greater reduction in serum uric acid level compared with the LAGB counterpart after adjusting for sex, age, and metabolic confounders (-2.3 ± 2.1 mg/dL versus-1.2 ± 1.1 mg/dL; P = .002). Patients with the rs712221 genotype exhibited better glycemic control and a greater serum uric acid reduction at 12 months after surgery. The effects of the rs712221 polymorphism in LMGB patients resulted in the greatest serum uric acid reduction (-2.7 ± 1.4 mg/dL).
  
  
  CONCLUSIONS
  For severely obese Han Chinese patients, bariatric surgery appears to reduce serum uric acid levels, potentially mediated by synergic effects of surgery type, BMI reduction, rs712221 locus, insulin sensitivity, and changed dietary factors via an unknown mechanism.
authors.affiliation: Comprehensive Weight Management Center, Taipei Medical University Hospital, Taipei, Taiwan (ROC); Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan (ROC).
authors.forename: Weu
authors.initials: W
authors.lastname: Wang
authors.affiliation: Obesity Research Center, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan (ROC); Graduate Institute of Injury Prevention, Taipei Medical University, Taipei, Taiwan (ROC).
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
authors.affiliation: Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan (ROC).
authors.forename: Wei-Jei
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Department of Nursing, En Hua Hospital, New Taipei, Taiwan (ROC).
authors.forename: Chung-Tan
authors.initials: CT
authors.lastname: Hsu
authors.affiliation: Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan (ROC).
authors.forename: Ming-Fen
authors.initials: MF
authors.lastname: Lee
authors.affiliation: Department of Nutrition and Health Sciences, Chang Jung Christian University, Tainan, Taiwan (ROC); Department of Medical Nutrition Therapy, Pan-Chiao Cathay Hospital, New Taipei, Taiwan (ROC). Electronic address: hsinhung@mail.cjcu.edu.tw.
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Chen
mesh_terms: D000328:Adult; D047628:Estrogen Receptor alpha / Q000235:genetics*; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D033461:Hyperuricemia / Q000235:genetics / Q000378:metabolism; D007333:Insulin Resistance / Q000235:genetics*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000235:genetics / Q000601:surgery*; D011110:Polymorphism, Genetic / Q000235:genetics; D014527:Uric Acid / Q000378:metabolism*; D015431:Weight Loss; D055815:Young Adult
chemical_list: C506487:ESR1 protein, human; D047628:Estrogen Receptor alpha; D014527:Uric Acid