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Prediction of insulin resistance and elevated liver transaminases using serum uric acid and derived markers in children and adolescents

European Journal of Clinical Nutrition (2024)Cite this article

Subjects

Abstract

Objective

To investigate the relationship of serum uric acid (Uacid) and derived parameters as predictors of insulin resistance (IR) and elevated liver transaminases in children and adolescents

Methods

Data of 1648 participants aged 10–18 years was analyzed using nationwide survey. Logistic regression analysis was performed with IR and elevated liver transaminases as dependent variables, and odds ratios (ORs) and 95% confidence intervals (CIs) for tertiles 2 and 3 of each parameter in comparison to tertile 1, which served as the reference. Receiver operating characteristic (ROC) curves were generated to assess predictability of the parameters for IR and elevated liver transaminases.

Results

Hyperuricemia, IR, and elevated liver transaminases were significantly associated with each other. All Uacid and derived markers showed continuous increase in ORs and 95% CIs for IR and elevated liver transaminases across the tertiles of several biochemical and metabolic variables of interest (all p < 0.001), and were also significantly predictive in ROC curve. Overall, Uacid combined with obesity indices showed higher ORs and area under the curve (AUC) compared to Uacid alone. Uacid-body mass index (BMI) standard deviation score presented the largest AUC for IR. For elevated liver transaminases, Uacid-BMI and Uacid-waist-to-height ratio showed the largest AUC.

Conclusions

Uacid combined with obesity indices are robust markers for prediction of IR and elevated liver transaminases in children and adolescents. Uacid and derived markers have potential as simple markers which do not require fasting for screening of IR and elevated liver transaminases in children and adolescents.

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Fig. 1: Flowchart of study population selection.
Fig. 2: ROC curve for each parameter to predict IR and ALT elevation.

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Data availability

The data used in this study is available in the KNHANES website. https://knhanes.kdca.go.kr/knhanes/main.do.

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Funding

Funding

This study was supported by a faculty research grant from Yonsei University College of Medicine (6-2021-0150).

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Authors and Affiliations

  1. Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Republic of Korea

    Youngha Choi

  2. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea

    Youngha Choi, Kyoung Won Cho, Seo Jung Kim, Sujin Kim, Myeongseob Lee, Junghwan Suh, Hyun Wook Chae, Ho-Seong Kim & Kyungchul Song

  3. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea

    Hyejin Yang & Soyoung Jeon

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Contributions

Youngha Choi was responsible for conceptualization, methodology, formal analysis, investigation and writing - original draft. Hyejin Yang was responsible for resources, data curation, formal analysis and writing - original draft. Soyoung Jeon was responsible for resources, data curation, formal analysis and writing - original draft. Kyoung Won Cho, Seo Jung Kim and Sujin Kim was responsible for conceptualization, methodology and writing - review & editing. Myeongseob Lee was responsible for methodology, investigation and writing - review & editing. Junghwan Suh was responsible for conceptualization, methodology and writing - review & editing. Hyun Wook Chae was responsible for conceptualization, methodology and writing - review & editing. Ho-Seong Kim was responsible for supervision and writing - review & editing. Kyungchul song was responsible for conceptualization, methodology, formal analysis, investigation and writing - review & editing.

Corresponding author

Correspondence to Kyungchul Song.

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Competing interests

The authors declare no competing interests.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of Yonsei University Gangnam Severance Hospital (IRB, 9-2023-0215).

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Informed consent was obtained from all subjects involved in the study.

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Supplementary information

41430_2024_1475_MOESM1_ESM.docx

Supplementary Table S1. Comparison of areas under receiver operating curves among each parameter for predicting IR and ALT elevation

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Choi, Y., Yang, H., Jeon, S. et al. Prediction of insulin resistance and elevated liver transaminases using serum uric acid and derived markers in children and adolescents. Eur J Clin Nutr (2024). https://doi.org/10.1038/s41430-024-01475-z

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