ASSESSMENT OF SERUM AND URINE URIC ACID LEVEL IN RELATION WITH ANTHROPOMETRIC INDICES IN OVERWEIGHT AND OBESE UNIVERSITY UNDERGRADUATE STUDENTS

Emmanuel Ikechukwu Onwubuya; Nkiruka Rose Ukibe; Ofia Anya Kalu; Solomon Nwabueze Ukibe; Obinwanne Chikamnario Osuagwu

doi:10.22159/ajpcr.2018.v11i9.27995

Authors

Emmanuel Ikechukwu Onwubuya Department of Medicine, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, P.M. B 5025, Anambra State, Nigeria.
Nkiruka Rose Ukibe Deparment of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, P. M. B 5025, Anambra State, Nigeria.
Ofia Anya Kalu Department of Medicine, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, P.M. B 5025, Anambra State, Nigeria.
Solomon Nwabueze Ukibe Department of Prosthesis and Orthotics, Federal University of Technology, Owerri, Imo State, Nigeria.
Obinwanne Chikamnario Osuagwu Deparment of Medical Laboratory Science, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, P. M. B 5025, Anambra State, Nigeria.

DOI:

https://doi.org/10.22159/ajpcr.2018.v11i9.27995

Keywords:

Uric acid, Anthropometric indices, Overweight, Obesity, Undergraduate students

Abstract

Objectives: Elevated uric acid level is related to a variety of adverse metabolic conditions including gout, obesity, and risk factor for cardiovascular diseases. This prospective study designed to assess the serum and urine uric acid level in relation with anthropometric indices in overweight and obese undergraduate students at NAU, Nnewi, Nigeria.

Methods: A total of 302 undergraduate students aged between 18 and 40 years were randomly recruited for the present study. They were grouped based on their body mass index (BMI) as overweight, obese, and control participants. 132 participants were males, of which 21 were obese, 34 were overweight while 77 were normal (control) males. 170 participants were females, of which 56 were obese, 62 were overweight while the remaining 52 were normal (control) females. Fasting blood and 24 h urine sample were aseptically collected from all the participants for determination of serum and urine uric acid.

Results: The study observed significantly higher serum uric acid level in obese and overweight males than female and control counterparts (p=0.000, respectively). Urine uric acid level was significantly higher in obese males and females than in their overweight and control counterparts (p=0.000). This shows increase production and accumulation of monosodium urate with decreased uric acid excretion which may result in hyperuricemia and hyperuricosuria which may result in gout. Serum and urine uric acid levels were significantly higher among age range (26â€“32) and (33â€“40) years compared with those among age range (18â€“25) (p<0.05) signifying that uric acid level increases with age. Serum and urine uric acid were significantly positively correlated with BMI, waist circumference, and waist hip ratio (p<0.05).

Conclusions: High serum uric acid is a prerequisite for gout and also associated with the metabolic syndrome and risk factors for cardiovascular disease. Proper awareness of the implication of hyperuricemia among undergraduate students is necessary.

Downloads

Download data is not yet available.

Author Biography

Emmanuel Ikechukwu Onwubuya, Department of Medicine, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, P.M. B 5025, Anambra State, Nigeria.

Department of Medical Laboratory Science, Snr Lecturer

References

Glantzounis GK, Tsimoyiannis EC, Kappas AM, Galaris DA. Uric acid and oxidative stress. Curr Pharm Des 2005;11:4145-51.

Sivakumar K, Thamarai R, Praghata RJ. Screening of serum uric acid in obese individuals in rural population. Inter J Sci Study 2014;2:1-4.

Rao DC, Laskarzewski PM, Morrison JA, Khoury P, Kelly K, Glueck CJ, et al. The clinical lipid research clinic family study: Familial determinants of plasma uric acid. Hum Genet 1982;60:257-61.

Rice T, Vogler GP, Perry TS, Laskarzewski PM, Province MA, Rao DC, et al. Heterogeneity in the familial aggregation of fasting serum uric acid level in five North American populations: The lipid research clinics family study. Am J Med Genet 1990;36:219-25.

Voruganti VS, Nath SD, Cole SA, Thameem F, Jowett JB, Bauer R, et al. Genetics of variation in serum uric acid and cardiovascular risk factors in Mexican Americans. J Clin Endocrinol Metab 2009;94:632-8.

Lockitch G, Halstead AC, Albersheim S, MacCallum C, Quigley G. Age- and sex-specific pediatric reference intervals for biochemistry analytes as measured with the ektachem-700 analyzer. Clin Chem 1988;34:1622-5.

Henry R. Normal values for selected blood and urine tests. J Humber Coll Toronto Canada 2000;2000:11-5.

Das M, Borah NC, Ghose M, Choudhury N. Reference ranges for serum uric acid among healthy Assamese people. Biochem Res Int 2014;2014:171053.

Underwood M. Diagnosis and management of gout. Br Med J 2006;332:339-42.

Roddy E, Zhang W, Doherty M. Is gout associated with reduced quality of life? A case-control study. Rheumatology (Oxford) 2007;46:1441-4.

Waring WS, Webb DJ, Maxwell SJ. Uric acid as a risk factor for cardiovascular disease. Quarterly J Med 2000;93:707-13.

Lin SD, Tsai DH, Hsu SR. Association between serum uric acid level and components of the metabolic syndrome. J Chin Med Assoc 2006;69:512-6.

Kang DH, Park SK, Lee IK, Johnson RJ. Uric acid-induced C-reactive protein expression: Implication on cell proliferation and nitric oxide production of human vascular cells. J Am Soc Nephrol 2005;16:3553 62.

Cain L, Shankar A, Ducatman AM, Steenland K. The relationship between serum uric acid and chronic kidney disease among Appalachian adults. Nephrol Dial Transplant 2010;25:3593-9.

Chuang SY, Chen JH, Yeh WT, Wu CC, Pan WH. Hyperuricemia and increased risk of ischemic heart disease in a large Chinese cohort. Int J Cardiol 2012;154:316-21.

Nagahama K, Inoue T, Kohagura K, Kinjo K, Ohya Y. Associations between serum uric acid levels and the incidence of hypertension and metabolic syndrome: A 4-year follow-up study of a large screened cohort in Okinawa, Japan. Hypertens Res 2015;38:213-8.

Conen D, Wietlisbach V, Bovet P, Shamlaye C, Riesen W, Paccaud F, et al. Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health 2004;4:9.

Liu PJ, Ma F, Lou HP, Zhu YN, Chen Y. Relationship between serum uric acid levels and metabolic syndrome in Chinese postmenopausal women. Climacteric 2014;17:148-54.

Wang H, Wang L, Xie R, Dai W, Gao C, Shen P, et al. Association of serum uric acid with body mass index: A Cross-sectional study from Jiangsu province, China. Iran J Public Health 2014;43:1503-9.

Masuo K, Kawaguchi H, Mikami H, Ogihara T, Tuck ML. Serum uric acid and plasma norepinephrine concentrations predict subsequent weight gain and blood pressure elevation. Hypertension 2003;42:474 80.

Ishizaka N, Ishizaka Y, Toda A, Tani M, Koike K, Yamakado M, et al. Changes in waist circumference and body mass index in relation to changes in serum uric acid in Japanese individuals. J Rheumatol 2010;37:410-6.

Toad JC. Clinical Diagnosis by Laboratory Method, Edited by Israel Davidson and John Bernord Henry. 14th ed. Philadelphia, PA: Saunders; 1969.

Seegmiller JE, Grayzel AI, Laster L, Liddle L. Uric acid production in gout. J Clin Invest 1961;40:1304-14.

Bandolier. Nurs Older People 2004;16:41.

Kuriyama S, Nakano T, Maruyama Y, Sugano N, Takane K, Suetsugu Y, et al. Relationship between serum uric acid levels and muscle strength/volume: A new insight from a large-scale survey. Nihon Jinzo Gakkai Shi 2014;56:1260-9.

Chiou WK, Huang DH, Wang MH, Lee YJ, Lin JD. Significance and association of serum uric acid (UA) levels with components of metabolic syndrome (MS) in the elderly. Arch Gerontol Geriatr 2012;55:724-8.

Palmer TM, Nordestgaard BG, Benn M, TybjÃ¦rg-Hansen A, Davey Smith G, Lawlor DA, et al. Association of plasma uric acid with ischaemic heart disease and blood pressure: Mendelian randomisation analysis of two large cohorts. BMJ 2013;347:f4262.

Duan Y, Liang W, Zhu L, Zhang T, Wang L, Nie Z, et al. Association between serum uric acid levels and obesity among university students (China). Nutr Hosp 2015;31:2407-11.

Alboqai OK, Odeh AA, Hourani HM, Al-Qudah F. Obesity and serum uric acid. Bahrain Med Bull 2007;29:88-90.

Matsuura F, Yamashita S, Nakamura T, Nishida M, Nozaki S, Funahashi T, et al. Effect of visceral fat accumulation on uric acid metabolism in male obese subjects: Visceral fat obesity is linked more closely to overproduction of uric acid than subcutaneous fat obesity. Metabolism 1998;47:929-33.

Jin M, Yang F, Yang I, Yin Y, Luo JJ, Wang H, et al. Uric acid, hyperuricemia and vascular diseases. Front Biosci (Landmark Ed) 2012;17:656-69.

Yin X, Zhou J, Yu D, Pan Q, Dong X, Zheng F et al. The correlation between serum uric acid level and abdominal obesity or metabolic syndrome. ZhonghuaNeiKeZaZhi 2014; 53: 13-8.

Dai X, Yuan J, Yao P, Yang B, Gui L, Zhang X, et al. Association between serum uric acid and the metabolic syndrome among a middle- and old-age Chinese population. Eur J Epidemiol 2013;28:669-76.

Yamashita S, Matsuzawa Y, Tokunaga K, Fujioka S, Tarui S. 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. Int J Obes 1986;10:255-64.

World Health Organisation. Obesity and Overweight; 2018. Available from: http://www.who.int/mediacentre/factsheets/fs311/en.

Drum DE, Goldman PA, Jankowski CB. Elevation of serum uric acid as a clue to alcohol abuse. Arch Intern Med 1981;141:477-9.

Bray GA, Paeratakul S, Popkin BM. Dietary fat and obesity: A review of animal, clinical and epidemiological studies. Physiol Behav 2004;83:549-55.

Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163-70.

Lin KC, Lin HY, Chou P. Community based epidemiological study on hyperuricemia and gout in Kin-Hu, Kinmen. J Rheumatol 2000;27:1045-50.

Tsushima Y, Nishizawa H, Tochino Y, Nakatsuji H, Sekimoto R, Nagao H, et al. Uric acid secretion from adipose tissue and its increase in obesity. J Biol Chem 2013;288:27138-49.

Rehman A, Naqvi SA. Serum and urinary uric acid in relation to age and sex. J Pak Med Assoc 1980;30:242-4.

Arromdee E, Michet CJ, Crowson CS, Oâ€™Fallon WM, Gabriel SE. Epidemiology of gout: Is the incidence rising? J Rheumatol 2002;29:2403-6.

Bhole V, de Vera M, Rahman MM, Krishnan E, Choi H. Epidemiology of gout in women: Fifty-two-year followup of a prospective cohort. Arthritis Rheum 2010;62:1069-76.

AntÃ³n FM, GarcÃa Puig J, Ramos T, GonzÃ¡lez P, OrdÃ¡s J. Sex differences in uric acid metabolism in adults: Evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. Metabolism 1986;35:343-8.

Zhang Q, Lou S, Meng Z, Ren X. Gender and age impacts on the correlations between hyperuricemia and metabolic syndrome in Chinese. Clin Rheumatol 2011;30:777-87.

Oyama C, Takahashi T, Oyamada M, Oyamada T, Ohno T, Miyashita M, et al. Serum uric acid as an obesity-related indicator in early adolescence. Tohoku J Exp Med 2006;209:257-62.

Sila-On A, Pavaro U, Nuchpramool W. Serum and urinary uric acid levels in healthy subjects and in patients with urolithiasis. J Med Assoc Thai 1991;74:352-7.

Harris CM, Lloyd DC, Lewis J. The prevalence and prophylaxis of gout in England. J Clin Epidemiol 1995;48:1153-8.

Klemp P, Stansfield SA, Castle B, Robertson MC. Gout is on the increase in New Zealand. Ann Rheum Dis 1997;56:22-6.

Abbott RD, Brand FN, Kannel WB, Castelli WP. Gout and coronary heart disease: The framingham study. J Clin Epidemiol 1988;41:237 42.

Geetha B, Manjula S, Shiv HN. Beneficial effects of coffee and maintenance of uric acid levels. Int J Pharm Pharm Sci 2016;8:393-5.

Grundy SM, Brewer HB Jr., Cleeman JI, Smith SC Jr., Lenfant C, National Heart, Lung, and Blood Institute. et al. Definition of metabolic syndrome: Report of the national heart, lung, and blood institute/American heart association conference on scientific issues related to definition. Arterioscler Thromb Vasc Biol 2004;24:e13-8.

Choi HK, Willett W, Curhan G. Coffee consumption and risk of incident gout in men: A prospective study. Arthritis Rheum 2007;56:2049-55.

Cohen SD, Kimmel PL, Neff R, Agodoa L, Abbott KC. Association of incident gout and mortality in dialysis patients. J Am Soc Nephrol 2008;19:2204-10.

Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: The third national health and nutrition examination survey. Arthritis Rheum 2005;52:283-9.

Janssens HJ, van de Lisdonk EH, Janssen M, van den Hoogen HJ, Verbeek AL. Gout, not induced by diuretics? A case-control study from primary care. Ann Rheum Dis 2006;65:1080-3.

Zhang H, Tamakoshi K, Yatsuya H, Murata C, Wada K, Otsuka R, et al. Long-term body weight fluctuation is associated with metabolic syndrome independent of current body mass index among Japanese men. Circ J 2005;69:13-8.

Onwubuya EI, Ukibe NR, Kalu OA, Emelumadu OF, Monago IN, Ukibe SN. Prevalence of overweight and obesity and assessment of lipid profile and fasting blood glucose levels among female premedical students at Nnamdi Azikiwe University, Nnewi Campus, Nigeria. Asian J Pharm Clin Res 2018;11:481-6.

Anandhasayanam A, Jimshad MI, Kannan S, Chander JS. Perception of paramedical students in a teaching institute on BMI, diet and social habitsâ€“a cross sectional survey. Int J Pharm Pharm Sci 2015;7:226-31.

Hauner H. Secretory factors from human adipose tissue and their functional role. Proc Nutr Soc 2005;64:163-9.

Kuzuya M, Ando F, Iguchi A, Shimokata H. Effect of aging on serum uric acid levels: Longitudinal changes in a large Japanese population group. J Gerontol A Biol Sci Med Sci 2002;57:M660-4.

Denzer C, Muche R, Mayer H, Heinze E, Debatin KM, Wabitsch M, et al. Serum uric acid levels in obese children and adolescents: Linkage to testosterone levels and pre-metabolic syndrome. J Pediatr Endocrinol Metab 2003;16:1225-32.

Andersson C, Weeke P, Brendorp B, KÃ¸ber L, FosbÃ¸l EL, Sharma AM, et al. Differential changes in serum uric acid concentrations in sibutramine promoted weight loss in diabetes: Results from four weeks of the lead-in period of the SCOUT trial. Nutr Metab (Lond) 2009;6:42.

Takahashi S, Yamamoto T, Tsutsumi Z, Moriwaki Y, Yamakita J, Higashino K, et al. Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism 1997;46:1162-5.

Hikita M, Ohno I, Mori Y, Ichida K, Yokose T, Hosoya T, et al. Relationship between hyperuricemia and body fat distribution. Intern Med 2007;46:1353-8.

Choi HK, Ford ES. Prevalence of the metabolic syndrome in individuals with hyperuricemia. Am J Med 2007;120:442-7.

Coutinho Tde A, Turner ST, Peyser PA, Bielak LF, Sheedy PF 2nd, Kullo IJ, et al. Associations of serum uric acid with markers of inflammation, metabolic syndrome, and subclinical coronary atherosclerosis. Am J Hypertens 2007;20:83-9.

Fruehwald-Schultes B, Peters A, Kern W, Beyer J, PfÃ¼tzner A. Serum leptin is associated with serum uric acid concentrations in humans. Metabolism 1999;48:677-80.