Association Between Hyperuricemia, Body Composition, and Comorbidities in an Obese Pediatric Population

Background: Childhood obesity is a global issue with multifactorial causes, leading to chronic and complex disease affecting all organs and systems with high morbidity and mortality, later in life. Elevated serum uric acid (SUA) levels are linked to several comorbidities in adults. In children, however, SUA levels vary by age, sex, and pubertal stage, and therefore, this relation is not well documented. While higher body mass index (BMI) has been associated with SUA levels, other nutritional assessment methods have not been thoroughly investigated and the link between SUA levels and obesity comorbidities in children is underexplored. Objective: This study aims to determine if hyperuricemia is related to body composition and obesity-related comorbidities in children. Methods: A retrospective analysis examined records from 505 obese children aged 5 to 18. The study evaluated the relationship between three nutritional assessment methods: BMI, waist-to-height ratio (WHtR), and body fat mass (BFM) percentage determined by bioimpedance (using InBody 270 scale), SUA levels, and blood markers associated with target organ damage. Results: A significant correlation was found between all three nutritional assessment methods (p < 0.001). WHtR showed a stronger correlation with the assessed comorbidities than the BMI z-score. SUA level correlated with HOMA-IR, ALT level, and lipid profile (p < 0.001). Multiple linear regression indicated an association between SUA level, BFM percentage, and WHtR (p < 0.001). Significant differences in body composition, SUA, and comorbidity markers were observed between children with and without hepatic steatosis (p < 0.05). Conclusion: Our results indicated a strong correlation among all nutritional assessment methods; however, WHtR and BFM percentage had a better correlation with obesity complications. SUA is a potential marker for insulin resistance, inflammation, and metabolic dysfunction-associated fatty liver disease (MAFLD) in obese children.