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Hyperuricemia prevalence reaches 44.50% in adolescents with obesity and correlates with metabolic dysfunctionObese adolescents show high rates of elevated uric acid levels

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Key Takeaway
Note that hyperinsulinemia and elevated ALT are independent risk factors for hyperuricemia in adolescents with obesity.

This guideline synthesizes data from an observational study of 200 adolescents with obesity to address the prevalence and risk factors of hyperuricemia (HUA). The study found a 44.50% prevalence of HUA, with higher rates observed in males (47.59%) compared to females (36.36%).

Key findings indicate that age over 12 years (OR = 2.60; 95%CI:1.19-5.68, P = 0.017), hyperinsulinemia (OR = 2.33; 95%CI:1.11-4.92, P = 0.026), and abnormal ALT (OR = 2.44; 95%CI:1.02-5.87, P = 0.046) are independent risk factors for HUA. Furthermore, positive dose-response relationships were observed between HUA risk and age, fasting insulin, ALT, and BMI z-score (all P < 0.05).

The authors emphasize the importance of comprehensive metabolic management for adolescents with obesity, specifically noting the roles of insulin sensitivity and liver function. However, the evidence is limited by the cross-sectional nature of the study and the specific regional setting. Clinical application should be tempered by the observational nature of the data and the specific population studied.

How this fits prior evidence

This finding extends the understanding of metabolic complications in pediatric populations. It specifically addresses the role of hyperinsulinemia as a risk factor for hyperuricemia in adolescents with obesity, which relates to prior evidence identifying insulin resistance as a key mediator linking metabolic status to chronic diseases.

Managing childhood obesity involves more than just weight. New data shows that many adolescents struggling with obesity also deal with high uric acid levels, a condition called hyperuricemia. In a study of 200 adolescents, nearly half of the participants showed these elevated levels. The rate was even higher in boys, where about 48% had high uric acid, compared to roughly 36% of girls.

Researchers found that several factors specifically increased the risk of high uric acid in these young people. These included being over the age of 12, having high fasting insulin, and having abnormal liver enzymes. These factors showed a clear link to the condition, suggesting that metabolic health and liver function are closely tied to uric acid levels in children.

While these findings highlight the importance of checking liver and insulin health in teens with obesity, it is important to note that this was an observational study of a specific group in one region. Because it was a single point in time, we cannot say for certain what caused these links, but the data suggests a need for more thorough metabolic checkups for these patients.

What this means for you:
High uric acid is common in adolescents with obesity and is linked to liver and insulin health.

Common questions

How common is high uric acid in children with obesity?

In a study of 200 adolescents with obesity, 44.50% were found to have high uric acid. This rate was slightly higher in males, where 47.59% of the boys had the condition, compared to 36.36% of the girls.

What other health factors are linked to high uric acid in teens?

The study found that being over 12 years old, having high fasting insulin, and having abnormal liver enzymes (ALT) were all independent risk factors for high uric acid in these adolescents.

What does this mean for treating adolescent obesity?

These findings suggest that doctors should look at the whole picture when treating teens with obesity. This includes checking liver function and insulin sensitivity, not just weight.

Study Details

Study typeGuideline
EvidenceLevel 5
PublishedAug 2026
View Original Abstract ↓
To investigate the prevalence of hyperuricemia (HUA) in adolescents with obesity in Guangxi, southern China, and explore its associations with hyperinsulinemia and hepatic injury. A total of 200 adolescents with obesity aged 10–18 years who visited the Children and Adolescents Weight Management Center of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from May to December 2025 were enrolled. According to the Clinical Practice Consensus Statement 2025: Management of Hyperuricemia and Gout in Adolescents (fasting serum uric acid ≥ 420 μmol/L for HUA), the subjects were divided into non-HUA and HUA groups. Anthropometric and fasting laboratory indicators were collected. Univariate analyses, multivariate logistic regression, and unadjusted restricted cubic spline (RCS) models were applied for statistical analyses. The prevalence of HUA was 44.50% (89/200), with 47.59% (69/145) in males and 36.36% (20/55) in females. Univariate analysis showed significant between-group differences in age, body mass index z-score (BMIZ), low-density lipoprotein cholesterol (LDL-C), fasting insulin, alanine aminotransferase (ALT), dyslipidemia, and hyperinsulinemia (all P < 0.05). Multivariate logistic regression revealed that age > 12 years (OR = 2.60, 95%CI:1.19–5.68, P = 0.017), hyperinsulinemia (OR = 2.33, 95%CI:1.11–4.92, P = 0.026) and abnormal ALT (OR = 2.44, 95%CI:1.02–5.87, P = 0.046) were independent risk factors for HUA. Restricted cubic spline models revealed positive dose-response relationships between age, fasting insulin, ALT, BMIZ and the risk of HUA (all P for overall < 0.05). HUA is highly prevalent among adolescents with obesity in Guangxi. Older age, hyperinsulinemia, and elevated ALT are independently associated with HUA risk. These findings highlight the importance of comprehensive metabolic management, including insulin sensitivity and liver function assessment, in this high-risk population.
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