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Background  To investigate the association of serum uric acid (SUA) with cardiometabolic abnormalities in Caucasian overweight/obese children (<10 years of age) versus adolescents (≥10 years of age) by drawing age and gender specific percentiles of uric acid.    Methods  Cross-sectional evaluation of 1364 Caucasian overweight/obese patients (age 4.1–17.9 years; 726 males, 53%; 560 children, 41%).    Results  SUA levels were significantly lower in children than in adolescents (4.74 ± 1.05 vs. 5.52 ± 1.49 mg/dl,  p  < 0.001) and peaked in 12–14 years-old boys and 10–12 years-old girls.  In children with levels of SUA in the highest quartile ( N  = 75, 13%), OR for high triglycerides was 4.145, 95% CI 1.506–11.407 ( p  = 0.009). In adolescents with SUA in the highest quartile ( N  = 274, 34%), ORs for insulin resistance was 2.399 (95%CI 1.4–4.113;  p  < 0.001); for impaired fasting glucose 2.184 (95% CI 0.877–5.441;  p  = 0.07); for impaired glucose tolerance 2.390 (95% CI 1.405–4.063;  p  = 0.001); and for high triglycerides 1.8, (95%CI 0.950–3.420;  p  = 0.05). Multivariable random-effect linear regression models demonstrated that waist circumference and age ( p  < 0.0001 for both) are the variables most significantly predicting SUA levels, followed by triglycerides ( p  = 0.005) and 2 h glucose ( p  = 0.03) while HOMA-IR and BMI z-score did not predict SUA.    Conclusions  High uric acid is associated with metabolic abnormalities and particularly with waist circumference very early in childhood.

Percentiles of serum uric acid and cardiometabolic abnormalities in obese Italian children and adolescents