Uric acid to high density lipoprotein-cholesterol ratio as a potential biomarker of comorbidities in youth with obesity.

BACKGROUND AND AIM: The uric acid to high-density lipoprotein-cholesterol ratio (UHR) has been associated with type 2 diabetes or hepatic steatosis in adults, while pediatric evidence is poor. We aimed to evaluate the association between UHR and several obesity-related comorbidities in youths with overweight or obesity (OW/OB).

METHODS AND

RESULTS

1215 youths of the CARITALY study were enrolled. Impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were assessed by standard methods. The homeostasis model assessment of insulin resistance (HOMA-IR) and the whole-body insulin sensitivity index (WBISI) were calculated. A continuous cardiometabolic risk score (cCMR) was calculated. Metabolic-associated steatotic liver disease (MASLD) was defined by a standard method. Mild reduced-estimated glomerular filtration rate (MReGFR) was defined by eGFR value > 60 < 90 ml/min/1.73 m2 White blood cell count (WBCc) was obtained. UHR was stratified into quartiles. Youths in the top UHR quartile showed a higher odds ratio (OR)(95%CI) of MReGFR: 2.03 (1.31-3.13) and cCMR: 2915 (1.60-4.24) vs the first quartile. Youths in the third UHR quartile showed significantly higher ORs of IFG 2.00 (1.01-3.94), IGT: 2.64 (1.37-5.10), HOMA-IR: 1.64 (1.17-2.29), and high WBCc: 2.49 (1.64-3.77), whereas youths yet in the second quartile showed significantly higher OR of low WBISI: 1.60 (1.04-2.50) and MASLD: 1.61 (1.13-2.28) vs the first quartile.

CONCLUSIONS

UHR was associated with disrupted glucose homeostasis, high cardiometabolic risk, MASLD, reduced glomerular filtration, and low-grade inflammation in youths with OW/OB. UHR is a promising biomarker for detecting obesity-related comorbidities in this population.