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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The insulin response to oral glucose and to i.v tolbutamide was stuied in a group of hyperuricemic subjects and in a group of weight-matched controls. Glucose tolerance was impaired only in obese hyperuricemic subjects. Insulin response to oral glucose was enhanced in hyperuricemic subjects. Tolbutamide gave rise to a sharp increase in IRI levels already 2 min after the injection and this rise was significantly higher in hyperuricemic subjects than in controls. The same result was observed also after i.v. fructose. The interpretation of these data is not easy. Uric acid plasma level and obesity do not seem to be directly involved because an abnormal IRI response has been observed also after a rapid fall in uric acid plasma level after allopurinol treatment and is evident also in lean subjects. In our opinion the problem is more complex and must be considered from the point of view of a change involving carbohydrate as well as purine metabolism.
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PMID:Insulin release in hyperuricemic patients. 59 3

As part of a study of the epidemiology of diabetes mellitus in middle-aged Swedish men, the present paper reports the prevalence and incidence of diabetes and the prevalence of impaired glucose tolerance. Two cohorts of 50-year-old men, representative of the corresponding male population of Gothenburg, Sweden, were examined in 1963 and 1973, respectively, and then followed until 1980. In the cohort of men born in 1913 (n = 855) the diabetes prevalence (WHO criteria), based on a questionnaire and fasting blood glucose, increased from 1.5% at age 50 to 7.6% at age 67. In the cohort of men born in 1923 (n = 226) the prevalence was 3.7% at age 50 and 4.0% at age 57. The overall prevalence of diabetes and impaired glucose tolerance was 25% among men born in 1913 (age 67) and 18% among men born in 1923 (age 57). The cumulative risk of developing diabetes from age 50 to 67 was 7.8%. Variables associated with impaired glucose tolerance and newly found diabetes, when degree of obesity was considered, were systolic blood pressure and triglycerides, well known risk factors for both coronary heart disease and diabetes. Uric acid, fasting insulin and glutamic puruvic transaminase, recently discussed as possible risk factors, were also associated with impaired glucose tolerance and newly found diabetes. Thus, both impaired glucose tolerance and newly found diabetes were associated with a clustering of risk factors, not only for diabetes but also for coronary heart disease.
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PMID:Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923. 367 59

Uric acid metabolism was investigated in 27 overweight subjects, 11 men (176 +/- 30 percent of ideal body weight) and 16 women (169 +/- 20 percent of ideal body weight). They were all hospitalized and treated with low-calorie diets (1,500-800 kcal/day) with gradual reduction of total calorie intake; exercise therapy (walking, and riding a bicycle ergometer) was added to this regimen afterwards. On admission, serum levels of uric acid were significantly elevated to 9.2 +/- 1.9 mg/dl in males (control 5.1 +/- 0.8 mg/dl) (P less than 0.001) and 6.8 +/- 1.9 mg/dl in females (control 4.4 +/- 1.0 mg/dl) (P less than 0.001), while the ratios (percentages) of uric acid clearance (CuA) to creatinine clearance (Ccr) were significantly reduced to 4.0 +/- 2.1 percent in males (control 10.8 +/- 2.2 percent) (P less than 0.001) and 5.2 +/- 3.1 percent in females (control 11.8 +/- 2.9 percent) (P less than 0.001). Urinary urate excretions were also lower in obese subjects than in controls. These data suggest that hyperuricemia in obese people is mainly attributed to an impaired renal clearance of uric acid rather than overproduction. In the course of weight reduction by a low-calorie diet, CuA/Ccr ratios gradually rose up to almost normal levels and serum levels of uric acid fell without significant changes in creatinine clearance. This increase of CuA/Ccr ratio was also preserved after starting exercise therapy. The normalization of urate excretion was observed even at the phase when their body weight was not fully reduced. Although the underlying mechanism of the impaired urate excretion in obese patients and its improvement during weight reduction is as yet unclear, hyperuricemia associated with obesity can be treated very well only with appropriate diet therapy and in most cases there is no need for drug therapy.
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PMID:Studies on the impaired metabolism of uric acid in obese subjects: marked reduction of renal urate excretion and its improvement by a low-calorie diet. 377 Oct 90

Several previous studies have demonstrated an increased prevalence of gout in New Zealand Maoris. The aetiology of the hyperuricaemia and its effect on morbidity, apart from gout, are unknown. A survey of 115 Maori men of working age revealed a history of gout in 10 (8%) and asymptomatic hyperuricaemia in 26 (23%). The relationship of hyperuricaemia with obesity was confirmed. Alcohol did not make an obvious contribution to the prevalence of hyperuricaemia. Hypertension was more common and creatinine clearance lower amongst those with gout, but not significantly so. The frequency of hypertension and mean creatinine clearance were similar to that seen in asymptomatic hyperuricaemia and normouricaemia. Urate clearance was lower in the gouty and hyperuricaemic subjects. The normouricaemic Maoris had a reduced fractional urate clearance compared with normal men elsewhere. They also excreted a relatively small proportion of hydrogen as ammonium. Both these features are characteristic of gout, and suggest that the Maoris' susceptibility to hyperuricaemia has a renal mechanism. Obesity is common amongst the Maoris and accentuates their natural tendency to hyperuricaemia.
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PMID:Hyperuricaemia, gout and kidney function in New Zealand Maori men. 648 33

Fasting plasma cholesterol, triglycerides and uric acid were measured in 109 Melanesian residents of Port Moresby and 71 residents of a Papuan coastal village. Cholesterol and triglyceride levels were low, mean cholesterol 3 . 74 and 3 . 70 mM/l and triglycerides 0 . 64 and 0 . 59 mM/l respectively in urban and rural residents, with no relation to age or sex. Uric acid was higher in urban men (0 . 37 mM/l) than either urban women (0 . 26 mM/l) or rural men and women (0 . 25 and 0 . 24 mM/l). The levels of plasma cholesterol found in this study are similar to previous reports on rural populations in Papua New Guinea. The apparent failure of plasma lipids to increase significantly in urbanised residents of port Moresby who had a significantly higher prevalence of both diabetes mellitus and obesity is unexplained.
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PMID:Plasma cholesterol, triglyceride and uric acid in urban and rural communities in Papua New Guinea. 700 59

In 1332 patients with different degrees of obesity (344 men, mean age 36 +/- 13 years, Broca Index 1.46 +/- 0.23; 988 women, mean age 37 +/- 13 years, Broca Index 1.67 +/- 0.30), cardiovascular risk factors (RF), serum HDL-cholesterol, and insulin levels were investigated. The most frequent RF was diastolic hypertension (68 per cent), followed by systolic hypertension (56 per cent), glucose intolerance (55 per cent), hypertriglyceridemia (31 per cent), hyperuricemia (19 per cent) and hypercholesterolemia (18 per cent). Only 9.4 per cent of the patients were without RF, and these patients were younger and less obese than patients with RF. Compared with controls, HDL-cholesterol levels were decreased in obese patients, however, the negative linear correlation between relative body weight and HDL-cholesterol levels was only significant in women, not in men. HDL-cholesterol levels were higher in women than in men. Serum insulin levels were correlated positively with relative body weight and negatively with age. Partial correlation analysis revealed a stronger influence of age than body weight on blood pressure, serum levels of total cholesterol, LDL-cholesterol, triglycerides and blood glucose levels. Uric acid levels correlated positively, and HDL-cholesterol levels negatively with relative body weight alone and not with age. On the basis of prevalence of RF, low serum HDL-cholesterol and high insulin levels, obese patients must be considered at high risk with respect to the development of cardiovascular disease.
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PMID:Cardiovascular risk factors and HDL-cholesterol levels in obesity. 701 54

Serum uric acid concentration and fractional excretion were evaluated in lean (n = 67) and obese (n = 56) girls before and during pubertal development. In both lean and obese girls, uricemia gradually increased as puberty advanced. Obese girls were hyperuricemic compared with lean controls (prepubertal: 184 +/- 83 v 130 +/- 29 mumol/L, P = .007; Tanner stage II-III: 190 +/- 53 v 178 +/- 47 mumol/L, NS; Tanner stage IV-V: 232 +/- 53 v 191 +/- 53 mumol/L, P = .02). Fractional excretion of urate decreased with puberty in lean girls (6.46% +/- 2.29%, 4.61% +/- 2.48%, and 3.54% +/- 1.84%), but not in obese subjects (3.74% +/- 2.27%, 4.01% +/- 1.90%, and 4.26% +/- 2.26%). Urate homeostasis was similar in prepubertal obese girls and in adolescent lean controls. We conclude that an increased serum urate concentration occurring at puberty may be due to decreased renal clearance of urate in lean girls, and at least in part to urate overproduction in obese subjects. Obesity may prematurely evoke changes in urate metabolism usually observed at puberty.
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PMID:Uric acid homeostasis in lean and obese girls during pubertal development. 802 3

Uric acid metabolism is not uniform throughout puberty. Serum urate increases progressively in obese boys as puberty advances, but it increases significantly only at the end of puberty in lean subjects. Urate filtered per unit of body weight increases in all subjects at the end of puberty when fractional excretion is diminished. Urate clearance decreases a the beginning of puberty in obese boys and at the end of puberty in lean subjects. Urate excretion corrected for body weight and the urinary uric acid to creatinine ratio do not change over the course of pubertal development in both lean and obese boys. These results suggest the following hypotheses: (1) renal retention of urate may represent the first mechanism by which uricemia is enhanced at puberty; (2) the kidney may finely modulate serum uric acid concentration through different mechanisms of urate handling, presumably occurring at different tubular sites; and (3) obesity may evoke sooner the urate changes that in lean boys are observed at the end of puberty.
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PMID:Urate changes in lean and obese boys during pubertal development. 859 90

We evaluated the effect of accumulation of intraabdominal visceral fat on the metabolism of uric acid in 50 healthy male subjects to elucidate any relationship between such obesity and hyperuricemia. The area of abdominal fat (visceral fat and subcutaneous fat) was measured at the level of the umbilicus by abdominal computed tomographic scanning. Serum and urinary concentrations of uric acid and creatinine were determined with an autoanalyzer. Uric acid clearance and the ratio of urinary uric acid to creatinine excreted in urine were calculated. Univariate and multivariate analyses were used to evaluate the relationship between uric acid metabolism and body fat. The size of the area of visceral fat was significantly correlated with the serum concentration of uric acid (r = .37, P < .01), uric acid clearance (r = -.34, P < .05), and the urinary uric acid to creatinine ratio (r = .65, P < .0001). The size of the area of subcutaneous fat was significantly correlated only with the urinary uric acid to creatinine ratio (r = .38, P < .01). Multivariate analyses, including body mass index (BMI), showed that the size of the visceral fat area was the strongest contributor to an elevated serum concentration of uric acid, a decrease in uric acid clearance, and an increase in the urinary uric acid to creatinine ratio. These results suggest that accumulation of visceral fat may have a greater adverse effect on the metabolism of uric acid than BMI or accumulation of subcutaneous fat. Clearly, patients with hyperuricemia should lose weight to reduce excessive visceral fat stores, to help avoid attacks of gout.
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PMID:Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. 932

Uric acid has been suggested as a risk factor in cardiovascular disease since the beginning of the twentieth century. While some clinical evidence have found a significant, specific and independent association between the uric acid serum level and cardiovascular morbidity and mortality, others came to an opposite conclusion. Hyperuricemia commonly coexists with hyperlipidaemia, hypertension, diabetes, obesity and others cardiovascular risk factors. This strong association makes the the role of risk factors difficult to separate out. Thus, the role of uric acid as an independent risk marker remains an open question.
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PMID:[Role of uric acid in cardiovascular diseases]. 1505 51


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