Ácido úrico sérico em crianças e adolescentes: distribuição e associação com fatores de risco cardiovascular
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Data
2020-03-06
Autores
Moulin, Stephanie Rezende Alvarenga
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Universidade Federal do Espírito Santo
Resumo
BACKGROUND: Hyperuricemia in adults is associated with cardiovascular diseases. However, there is lack of information regarding serum uric acid (SUA) determinants in children and adolescents. Our purpose was to determine the SUA distribution in schoolchildren and the possible association between increased SUA levels and cardiovascular risk factors. METHODS: A fasting blood sample was collected from 1.750 children and adolescents (6-18 years, 56% boys) enrolled in institution called Estação Conhecimento, Serra/ES, Brazil. Internal cut-offs were generated to define hyperuricemia (≥90th percentile of SUA concentration for sex and age group). Puberty was defined according to Tanner scale. Body weight and fat mass was determined with a bioimpedance scale. Data are given as mean ± standard deviation. RESULTS: The degree of puberty, age and sex influence the distribution of AUS, and the average of AUS was higher among individuals who had already entered puberty (4.2 ± 1.1 mg/dL) than in the prepubescent ones. (3.6 ± 0.8 mg/dL; p <0.001), with a greater difference between male pubertal (4.4 ± 1.2 mg / dL) compared to females (4.0 ± 1.0 mg / dL; p <0.001). The following uric acid reference values (p90 for sex and age group) was proposed: under 10 years: ≤ 4.8 mg/dL; from 10 to 13 years: ≤ 5.7 mg/dL in boys ≤ 5.2 mg/dL in girls; and 14 to 17 years: ≤ 6.4 mg/dL in boys ≤ 5.3 mg/dL in girls. Hyperuricemia was associated with overweight/obesity (OR 3.5 CI 95% 2.6-4.8), high waist circumference (OR 3.7 CI 95% 2.7-5.1), dyslipidemia (OR 2.8 95% CI 1.94.1), high blood pressure (OR 1.9 95% CI 1.1-3.3), high fat percentage (8,7% vs. 21,1% - OR 2.8 IC 95% 1.9-4.1), metabolic syndrome (OR 3.3 95% CI 1.6-6.7) and hyperinsulinemia (OR 2.0 95% CI 1.3-3.1). Individuals in the fourth quartile of AUS compared to those in the first quartile had higher age, pIMC, waist circumference, percentage of fat and lean mass. Using a reference value of 5.5mg/dL, the prevalence of hyperuricemia in children and adolescents was 10.3% of the sample. Lean mass was the main variable independently associated with higher AUS values. CONCLUSION: Higher AUS values are associated with higher cardiovascular risk in childhood and adolescence. The main cardiovascular risk factors associated with hyperuricemia in this population were overweight/obesity, high waist circumference, dyslipidemia, high fat percentage, high blood pressure, hyperinsulinemia and metabolic syndrome
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Ácido úrico , Fatores de risco , Doenças cardiovasculares , Crianças , Uric acid , Risk factors , Cardiovascular diseases , Children