Obesity and Increased Uric Acid

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. Uric acid, the form of ions and salts is a by product of chemical after the body breaks down purines, the substance is found in many foods, including Asparagus, Bacon, Beef, Bluefish, Bouillon, Calf tongue, Carp, Cauliflower, Chicken, Chicken soup, Codfish, Crab, Duck, Goose, etc.. High levels of uric acid in blood serum can be harmful, leading to gout and forming of kidney stones.

C. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

D. How Obesity associates with Increased Uric Acid
1. Acccording to the study of "Serum uric acid as an obesity-related indicator in early adolescence" by Oyama C, Takahashi T, Oyamada M, Oyamada T, Ohno T, Miyashita M, Saito S, Komatsu K, Takashina K, Takada G. (Source from Department of Pediatrics, Akita University School of Medicine, Akita, Japan. Tohoku J Exp Med. 2006 Jul;209(3):257-62), posted in PubMed, researchers found that In general, children are evaluated as obesity, when POW is equal to or more than 20% (>or= 20%). Serum uric acid levels are positively correlated with obesity-related indicators, BMI and POW, in both boys and girls. Serum uric acid levels of the subjects with high POW (>or= 20%) are significantly higher than those of the subjects with low POW (< 20%) in both boys and girls. These results suggest that serum uric acid levels are significantly increased with obesity and could be used as one of obesity-related indicators even in early adolescence.

2. In an abstract of study of "Recent trends of hyperuricemia and obesity in Japanese male adolescents, 1991 through 2002" by Ogura T, Matsuura K, Matsumoto Y, Mimura Y, Kishida M, Otsuka F, Tobe K. (Source from Health and Medical Center, Okayama University, Okayama, Japan. Metabolism. 2004 Apr;53(4):448-53), posted in PubMed, researchers found rhat Hyperuricemia was related to the presence of other risk factors, including hypercholesterolemia, liver function abnormality, and hypertension. The frequencies of such abnormalities were higher than euuricemic subjects and this trend was notable in the most recent students enrolled from 1999 through 2002. Hyperuricemia was even found in the group of non-obese male adolescents. Taking into consideration that hyperuricemia is associated with a high prevalence of lifestyle-related diseases in adults, it is of great importance to prevent hyperuricemia at the early stage in Japanese adolescents.

3. In a study of "[Uric acid nephrolithiasis]", [Article in French], by Dussol B. (Source from Centre de néphrologie et de transplantation rénale, hôpital de la Conception, 13385 Marseille Cedex 05. bertrand.dussol@ap-hm, Rev Prat. 2011 Mar;61(3):389-92), posted in PubMed, researcher indicated that Its frequency will increase in the next decades because of the ageing and the increasing prevalence of obesity and type 2 diabetes mellitus. The pathophysiologic defect is an excessively acidic urine pH rather than hyperuricosuria. Undissociated uric acid is poorly soluble in acidic urines (pH < 5.5) but solubility increases when sodium urate forms at higher pH. Insulin resistance may contribute to the development of acidic urine because of higher net acid excretion. Because uric acid kidney stones are radiolucent, diagnosis is based on echography and tomodensitometry. Medical management strategies focus primarily on alkali treatment and/or decreasing hyper-uricosuria.

4. According to a study of "Uric acid nephrolithiasis" by Liebman SE, Taylor JG, Bushinsky DA. (Source from University of Rochester School of Medicine and Dentistry, Nephrology Division, Strong Memorial Hospital, Rochester, NY 14642, USA. scott_liebman@urmc.rochester.edu, Curr Rheumatol Rep. 2007 Jun;9(3):251-7.), posted in PubMed, researchers found that Uric acid nephrolithiasis is typically found in individuals with a low urine pH and a normal concentration of urinary uric acid. Patients with a history of gout are at greater risk of forming uric acid stones, as are patients with obesity, diabetes, or the complete metabolic syndrome. The unifying renal tubular abnormality of these disorders appears to be the excretion of abnormally acidic urine. This article focuses on the relationship of these disorders to the development of uric acid stones.

5. According to a study of "Relation of uric acid with components of metabolic syndrome before and after Roux-en-Y gastric bypass in morbidly obese subjects" by Serpa Neto A, Rossi FM, Valle LG, Teixeira GK, Rossi M. (Source from Division of Clinical and Surgical Treatment of Obesity, Faculdade de Medicina do ABC, Santo André, SP, Brazil. aryserpa@terra.com.br, Arq Bras Endocrinol Metabol. 2011 Feb;55(1):38-45.), posted in PubMed, researchers indicated in abstract that Concentrations of uric acid were associated with the prevalence of metabolic abnormalities in this sample of morbidly obese patients. Also, weight loss after RYGBP can reduce uric acid levels and the prevalence of hyperuricemia.

6. Etc.

E. Treatments of Obesity and Increased Uric Acid
1. According to the abstract of the study of "Obesity and urolithiasis" by Asplin JR. (Source from Litholink Corporation, Chicago, IL 60612, USA. jasplin@litholink.com, Adv Chronic Kidney Dis. 2009 Jan;16(1):11-20), posted in PubMed, researchers stated that Obesity can increase stone risk in multiple ways. Excess nutritional intake increases traffic of lithogenic substances such as calcium, oxalate, and uric acid. Metabolic syndrome, commonly associated with obesity, alters renal acid-base metabolism, resulting in a lower urine pH and increased risk of uric acid stone disease......, Certainly, the many health risks of obesity, including urolithiasis, necessitate weight loss, but recognition of the potential complications of such therapies is required to prevent induction of new and equally severe medical problems. The optimal approach to weight control that minimizes stone risk needs to be determined.

2. In a study of "Body size and 24-hour urine composition" by Taylor EN, Curhan GC. (Source from Renal Division and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. entaylor@partners.org, Am J Kidney Dis. 2006 Dec;48(6):905-15), posted in PubMed, researchers filed the conclusion of Positive associations between BMI and urinary calcium excretion likely are due to differences in animal protein and sodium intake. The greater incidence of kidney stones in the obese may be due to an increase in uric acid nephrolithiasis.

3. In abstract of the study of "Benefits of sustained moderate weight loss in obesity" by Pasanisi F, Contaldo F, de Simone G, Mancini M. (Source from Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy. pasanisi@unina.itm Nutr Metab Cardiovasc Dis. 2001 Dec;11(6):401-6.), posted in PubMed, researchers found that a large number of obese patients may be sensitive to a modest weight loss even without the achievement of ideal body weight. Sustained moderate weight loss by itself is definitely beneficial in obesity (especially "malignant" and "morbid" obesity), but also in diabetes, hypertension, hyperlipidaemia, cardiorespiratory diseases and other chronic degenerative diseases associated with any degree of excess body fat.

4. Etc.

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