Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia

Abstract

Objective: Serum uric acid (sUA) is believed to contribute to the pathogenesis of metabolic comorbidities like hypertension, insulin-resistance (IR) and endothelial dysfunction (EDF) in obese children. The present pilot study investigated the association between sUA concentrations and loss of body weight following laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y-gastric bypass (RYGB) in severely obese adolescents.

Materials/methods: 10 severely obese adolescents underwent either LSG (n=5) or RYGB (n=5). 17 normal weight, healthy, age- and gender-matched adolescents served as a normal weight peer group (NWPG). Pre- and 12 months postoperatively, sUA and relevant metabolic parameters (glucose homeostasis, transaminases, lipids) were compared.

Results: Preoperatively, sUA was significantly elevated in patients with severe obesity compared to NWPG. Twelve months after LSG and RYGB, a significant decrease in sUA, BMI, CVD risk factors, hepatic transaminases, and HOMA-IR was observed. Reduction in SDS-BMI significantly correlated with changes in sUA.

Conclusions: sUA levels and metabolic comorbidities improved following bariatric surgery in severely obese adolescents. The impact of changes in sUA on long-term clinical complications of childhood obesity deserves further study.

Keywords: ALAT; ASAT; Adolescents; BMI; CVD; FPG; FPI; LSG; Laparoscopic sleeve gastrectomy (LSG); MRM; Morbid obesity; RYGB; Roux-Y gastric bypass (RYGB); Roux-en-Y gastric bypass; TG; Uric acid; alanine aminotransferase; aspartate aminotransferase; body mass index; cardiovascular disease; dBP; diastolic blood pressure; fasting plasma glucose; fasting plasma insulin; laparoscopic sleeve gastrectomy; multiple reaction monitoring; sBP; sUA; serum uric acid; systolic blood pressure; triglycerides; γ-GT; γ-glutamyl transferase, HOMA-IR, homeostasis model assessment-insulin-resistance.