Uric acid best predicts metabolically unhealthy obesity with increased cardiovascular risk in youth and adults§


  • Disclosures: All authors have read the journal's policy on disclosure of potential conflicts of interest. The authors have no potential conflicts of interest to declare.

  • Funding agencies: This work was funded by the “Zukunftsfond Steiermark” Project “STYJOBS-Extension”. Furthermore, the Austrian Nano-Initiative co-financed this work as part of the Nano-Health project (no. 0200), the sub-project NANO-PLAQUE being financed by the Austrian FWF (Fonds zur Förderung der Wissenschaftlichen Forschung, Project no. N212-NAN). Financial support of a technician and consumables associated with the set up of the STYJOBS EDECTA Cohort.

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    Abbreviations: BMI, body mass index; CHE, cholinesterase; CI, Confidence interval; AST/GOT, Aspartat-Aminotransferase; ALT/GPT, Alanin-Aminotransferase; gamma-GT, Gammaglutaryltransferase; CCA, Common carotid arteries; CT, Computed tomography; CRP, C-reactive protein; HDL, High dense lipoprotein; HOMA-IR, Homeostatic model assessment – insulin resistance; IL-6, Interleukin-6; IMT, Intima media thickness; MetS, Metabolic syndrome; oxLDL, Oxidized low dense lipoprotein; SAT, Subcutaneous adipose tissue; US-CRP, Ultra sensitive c-reactive protein; UA, Uric acid; VAT, Visceral adipose tissue; WHR, Waist-to-Height Ratio.



The obesity prevalence is growing worldwide and largely responsible for cardiovascular disease, the most common cause of death in the western world. The rationale of this study was to distinguish metabolically healthy from unhealthy overweight/obese young and adult patients as compared to healthy normal weight age matched controls by an extensive anthropometric, laboratory, and sonographic vascular assessment.

Design and Methods:

Three hundred fifty five young [8 to < 18 years, 299 overweight/obese(ow/ob), 56 normal weight (nw)] and 354 adult [>18-60 years, 175 (ow/ob), 179 nw)] participants of the STYJOBS/EDECTA (STYrian Juvenile Obesity Study/Early DEteCTion of Atherosclerosis) cohort were analyzed. STYJOBS/EDECTA (NCT00482924) is a crossectional study to investigate metabolic/cardiovascular risk profiles in normal and ow/ob people free of disease except metabolic syndrome (MetS).


From 299 young ow/ob subjects (8-< 18 years), 108 (36%), and from 175 adult ow/ob subjects (>18-60 years), 79 (45%) had positive criteria for MetS. In both age groups, prevalence of MetS was greater among males. Overweight/obese subjects were divided into “healthy” (no MetS criterion except anthropometry fulfilled) and “unhealthy” (MetS positive). Although percentage body fat did not differ between “healthy” and “unhealthy” ow/ob, nuchal and visceral fat were significantly greater in the “unhealthy” group which had also significantly higher values of carotid intima media thickness (IMT). With MetS as the dependent variable, two logistic regressions including juveniles <18 years or adults >18 years were performed. The potential predictor variables selected with the exception of age and gender by t test comparisons included IMT, ultrasensitive c-reactive protein (US-CRP), IL-6, malondialdehyde (MDA), oxidized LDL, leptin, adiponectin, uric acid (UA), aldosterone, cortisol, transaminases, fibrinogen. In both groups, uric acid and in adults only, leptin and adiponectin, turned out as the best predictor.


Serum levels of UA are a significant predictor of unhealthy obesity in juveniles and adults.