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Hyperuricemia in children and adolescents with obesity –⁠ a review of current knowledge


Authors: Jan Boženský 1;  Eva Havránková 2,3;  Magdalena Pencová 4;  Pavel Ješina 4
Authors‘ workplace: Dětské oddělení, Nemocnice AGEL Ostrava-Vítkovice 1;  Olivova dětská léčebna, o. p. s., Říčany u Prahy 2;  Pediatrická klinika, 1. lékařská fakulta, Univerzita Karlova a Fakultní Thomayerova nemocnice, Praha 3;  Metabolické centrum, Klinika pediatrie a dědičných poruch metabolismu, 1. lékařská fakulta, Univerzita Karlova a Všeobecná fakultní nemocnice, Praha 4
Published in: Čes-slov Pediat 2026; 81 (Supplementum): 28-32.
Category:
doi: https://doi.org/10.55095/CSPediatrie2026/006

Overview

Hyperuricemia is a common, yet often overlooked, metabolic comorbidity of childhood obesity. Although gout is rare in children, chronic elevation of uric acid can have similar systemic consequences as in adults –⁠ including the development of arterial hypertension, insulin resistance, and kidney damage. This article summarizes current knowledge about its prevalence, pathophysiology, consequences, diagnosis and treatment in children and adolescents with obesity.

Keywords:

obesity – prevention – allopurinol – Uric acid – cardiovascular risk – children – hyperuricemia


Sources

1. Major TJ, Dalbeth N, Stahl EA, et al. An update on the genetics of hyperuricaemia and gout. Nat Rev Rheumatol 2018; 14(6): 341–353.

2. Tin A, Marten J, Halperin Kuhns VL, et al. Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels. Nat Genet 2019; 51(10): 1459–1474.

3. Kubota M. hyperuricemia in children and adolescents: present knowledge and future directions. J Nutr Metab 2019.

4. Doležel Z, Jesina P, Stiburkova B. Severe hyperuricemia in two children with acute gastroenteritis: Questions. Pediatr Nephrol 2020; 35(8): 1429–1430.

5. Du L, Zong Y, Li H, et al. Hyperuricemia and its related diseases: mechanisms and advances in therapy. J Signal Transduct Target Ther 2024; 9(1): 212.

6. Gong M, Wen S, Nguyen T, et al. converging relationships of obesity and hyperuricemia with special reference to metabolic disorders and plausible therapeutic implications. Diabetes Metab Syndr Obes 2020; 13 : 943–962.

7. Toyoki D, Shibata S, Kuribayashi-Okuma E, et al. Insulin stimulatesuric acid reabsorption via regulating urate transporter 1 and ATP-binding cassette subfamily G member 2. Am J Physiol Renal Physiol.2017; 313(3): F826–F834.

8. Sautin YY, Nakagawa T, Zharikov S, et al. Adverse effects of the classic antioxidant uric acid in adipocytes: NADPH oxidase-mediated oxidative/nitrosative stress. Am J Physiol Cell Physiol 2007; 293(2): C584–96.

9. Larsson SC, Burgess S,  Michaëlsson K. Genetic association between adiposity and gout: a Mendelian randomization study. Rheumatology (Oxford) 2018; 57(12): 2145–2148.

10. Lyngdoh T, Vuistiner P, Marques-Vidal P, et al. Serum uric acid and adiposity: deciphering causality using a bidirectional Mendelian randomization approach. PLoS One 2012.

11. Pacifico L, Cantisani V, Anania C, et al. Serum uric acid and its association with metabolic syndrome and carotid atherosclerosis in overweight/obese children. Eur J Endocrinol 2009; 160(1): 45–52.

12. Niu F, Li Y, Zhao Y, et al. Obesity-induced insulin resistance is mediated by high uric acid in obese children and adolescents: a mendelian randomization analysis. Front Endocrinol 2021; 12.

13. Jørgensen RM, Bøttger B, Vestergaard ET, et al. Uric acid is elevated and associated with anthropometric and metabolic risk markers in children with obesity and decreases after weight loss. Front Pediatrics 2022; 9 : 814166.

14. Vasco J, Tavares M, Mansilha HF. Association between hyperuricemia, body composition, and comorbidities in an obese pediatric population. J Nutr Metab 2025.

15. Stiburkova B, Lukesova M, Zeman J. Pediatrics hyperuricemia in clinical practice: A retrospective analysis in 1753 children and adolescents with hyperuricemia Joint Bone Spine 2025; 92(1).

16. Taner S, Gezici E, Unal A, et al. The association of obesity and hyperuricemia with ambulatory blood pressure in children. .Pediatr Nephrol 2025; 40(3): 787–796.

17. Wei Y,  Zhu J, Wetzstein SA. Plasma and water fluoride levels and hyperuricemia among adolescents: A cross-sectional study of a nationally representative sample of the United States for 2013-2016 Ecotoxicol Environ Saf 2021.

18. Lee JH. Prevalence of hyperuricemia and its association with metabolic syndrome and cardiometabolic risk factors in Korean children and adolescents: analysis based on the 2016-2017 Korea National Health and Nutrition Examination Survey. Korean J Pediatr 2019; 62(8): 317–323.

19. Rao J, Ye P, Lu J, et al. Prevalence and related factors of hyperuricaemia in Chinese children and adolescents: a pooled analysis of 11 population-based studies. China Child and Adolescent Hyperuricemia Study (CCAHS) Consortium. Ann Med 2022; 54(1): 1608–1615.

20. Honda M, Horiuchi H, Torii T, et al. Urate-lowering therapy for gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database BMC Pediatr 2021; 21(1): 581.

21. www.vfn.cz/pacienti/kliniky-ustavy/ustav-lekarske-biochemie-a-laboratorni-diagnostiky/

22. Flynn, JT, Kaelber, DC, Baker-Smith, CM, et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140(3).

23. Yumuk V, Tsigos C, Fried M, et al. European guidelines for obesity management in adults. Obesity Facts 2015; 8(6): 402–424.

24. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: a clinical practice guideline. Canad Med Assoc J 2020; 192(31): E875–E891.

25. Togashi K, Masuda H, Iguchi K. Effect of diet and exercise treatment for obese Japanese children on abdominal fat distribution Res Sports Med 2010; 18(1): 62–70.

26. Floriánková M, Bláhová Š, Pencová M, et al. Nutriční terapie u pacientů s dědičnými poruchami metabolismu. Čes-slov Pediatr 2018; 73 (6): 395–407.

27. Krzystek-Korpacka M, Patryn E, Kustrzeba-Wojcicka I, et al. The effect of a one-year weight reduction program on serum uric acid in overweight/obese children and adolescents Clin Chem Lab Med 2011; 49(5): 915–921.

28. Chen Z, Xue X, Ma L, et al. Effect of low-purine diet on the serum uric acid of gout patients in different clinical subtypes: a prospective cohort study Eur J Med Res 2024; 29 : 449.

29. Nicholls A, Scott JT. Effect of weight-loss on plasma and urinary levels of uric acid. Lancet 1972; 2(7789): 1223–4.

30. Liu X, Wang X, Cui L. Association between oral vitamin C supplementation and serum uric acid: A meta-analysis of randomized controlled trials Complement Ther Med 2021 : 60.

31. Qin X, Li Y, He M, et al. Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT). Am J Clin Nutr 2017; 105(4): 882–889.

32. Zhang Y, Qiu HJ. Folate, vitamin B6 and vitamin B12 intake in relation to hyperuricemia. Clin Med 2018; 7(8): 210.

33. Fitzgerald JD, Dalbeth N, Mikuls T, et al. American College of Rheumatology Guideline for the management of gout. Arthritis Care Res (Hoboken) 2020; 72(6): 744–760.

34. Sapankaew T, Thadanipon K, Ruenroengbun N, et al. Efficacy and safety of urate-lowering agents in asymptomatic hyperuricemia: systematic review and network meta-analysis of randomized controlled trials BMC Nephrol 2022; 23(1): 223.

35. Sampson AL, Singer RF, Walters GD. Uric acid lowering therapies for preventing or delaying the progression of chronic kidney disease. Cochrane Database Syst Rev 2017; (10).

36. Li L, Yang C, Zhao Y, et al. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease?: a systematic review and meta-analysis based on observational cohort studies. BMC Nephrol 2014; 15(1): 1–2.

37. Vrablik M, Borghi C, Rosolová H, et al. Diagnostika a léčba hyperurikemie v kardiovaskulární prevenci na základě patofyziologického mechanismu jejího vzniku –⁠ Expertní konsenzus českých a slovenských odborníků 2024. Vnitr Lek 2024; 70(8): 491–500.

38. Somkrua R, Eickman E, Saokaew S, et al. Association of HLA-B*5801 allele and allopurinol-induced Stevens Johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis. BMC Med Genet 2011; 12 : 118.

39. Gokcel A, Gumurdulu Y, Karakose H, et al. Evaluation of the safetyand efficacy of sibutramine, orlistat and metformin in the treatmentof obesity. Diabetes Obes Metab 2002; 4(1): 49–55.

40. Barskova V, Eliseev M, Kudaeva F, et al. Effect of metformin on theclinical course of gout and insulin resistance. Klin Med 2009; 87(7): 41–46.

41. Zhao Y, Xu L, Tian D, et al. Effects of sodium-glucose co-transporter2 (SGLT2) inhibitors on serum uric acid level: A meta-analysis of ran-domized controlled trials. Diabetes Obes Metab 2018; 20(2): 458–462.

42. Najafi, S, Bahrami, M, Butler, AE, et al. The effect of glucagonlike peptide1 receptor agonists on serum uric acid concentration: A systematic review and metaanalysis. Br J Clin Pharmacol 2022; 88(8): 36273637.

43. Kaneko K, Tsuruga K, Takayanagi F, et al. Daily amount of purine in commonly recommended well-balanced diets in Japan and overseas. Nutrients 2024; 16(23): 4066.

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Neonatology Paediatrics General practitioner for children and adolescents
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