Objective: To evaluate the concentration of UrA in children and adolescents. Blood was collected fasting h for analysis of laboratory parameters, and blood pressure and anthropometric measures were verified. According to the For comparisons between age ranges, UrA Keywords: uric acid; child; adolescent; reference values; hyperuricemia.
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Uric acid UrA is an organic compound, product of purine catabolism, through the catalytic effect of xanthine oxidase. Variation in serum UrA level is multifactorial and comes under the influence of environmental and genetic factors.
The excretion of approximately two-thirds is through the kidneys; the remaining one-third, through the intestinal tract 1. Despite the apparent antioxidant activity of UrA 2 , the results of some studies highlighted the association of hyperuricemia hUrA with several risk factors for cardiometabolic diseases CMD , including hypertension, diabetes, endothelial dysfunction, obesity, and metabolic syndrome, both in adults and in children and adolescents In childhood and adolescence, the presence of hUrA can pose a serious risk of CMD, and it can persist or become more evident until adult life.
For this reason, early identification is important for the adoption of prevention measures in the youth population 6. However, although the reference values for children and adolescents are established , the guidelines of the International Federation of Clinical Chemistry and Laboratory Medicine IFCC suggest the determination of the reference interval by obtaining the 95 percentile 95 th value for the different populations, also considering their peculiarities, age and sex, especially among children 11, Thus, the objective of the present study was to assess the serum UrA concentration in children and adolescents, who were stratified by age ranges and by sex.
The 95 th percentile was calculated to obtain the hUrA threshold for the participating students. This is a cross-sectional study covering 1, students, what accounts for Participants were students self-reported Caucasians, who did not suffer from any disease, did not use any medication, and were aged between 5 and 15 years.
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For calculation of the 2. Therefore, the students considered eutrophic amounted to boys and girls. It is worth noting that nowadays fasting is not required for assessing lipid profile However, upon the study conduction, the new standardization had not taken place yet. Insulin and high-sensitivity C-reactive protein hsCRP were measured by an enzyme-labeled chemiluminescent immunometric assay, with an Immulite analyzer Siemens Healthcare, United Kingdom.
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Blood pressure BP was recorded using cuff and sphygmomanometer, with students on the seated position Initially, a five-minute rest was observed, and then two measures were taken with a five-minute interval, choosing the lowest measure. Weight kg and height m were measured using a scale with capacity of kg and precision of g and stadiometer with a capacity of 2 m and precision of 0. Waist circumference WC was determined using the measure between the lower rib and the upper border of the iliac crest, with flexible inelastic measuring tape, as described by Taylor et al.
For UrA, the For the classification of pre-hypertension and stages 1 and 2 hypertension, the cut-off points stratified by sex, age and height 17 were considered. Subjects who reported the use of medication or did not present the consent form were excluded from the study.
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Categorical results are quantitatively presented as mean and standard deviation SD , or median and interquartile range. For statistical analysis of the variables, data were first tested for normality Kolmogorov-Smirnov. Transformation was used for quantitative data without normal distribution. Student's t test or Mann-Whitney test were applied when data were normally distributed or not, respectively.
For evaluation of UrA in the age ranges, the paired t test was used for mean analysis, the 2. For establishing reference limits for UrA by the 95 th percentile, the interval between 2. All analyses were performed in the software MedCalc version In the eutrophic analyzed students mean age 9. Alteration in renal function was not observed by means of measurement of serum creatinine results not shown.
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The mean concentration of UrA found in the population of students assessed was 3. The mean serum concentration of UrA was increasing in the different age ranges in both sexes, and significant intragroup differences were observed for all ranges Table 2. In relation to the In the present study, the evaluation of UrA in the eutrophic students, from a population of 1, individuals aged years , stratified by age ranges and sex, resulted from the exclusion of those presenting alterations in parameters associated with hUrA.
Among them, excess body weight, evaluated by BMI and increased WC, whose association is linked to insulin resistance and higher leptin production, with both reducing UrA renal excretion From the current analysis were also excluded students with insulin resistance, hypertriglyceridemia, and low HDL levels, besides high blood pressure, because these components, as well as increased WC, are used for classification of metabolic syndrome and associated with hUrA The use of age ranges has as indicative the three intimately related interactive processes that occur in children and adolescents: growth, maturation, and development 20, According to the review by Rogol et al.
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