Interrelationships of hyperuricemia, insulin resistance, and stages of obesity

BACKGROUND: Obesity and hyperuricemia (HU) as metabolically and genetically similar conditions with a single list of comorbid diseases are of serious concern to the global scientific community.

AIM: to assess the incidence of GU and the severity of insulin resistance with different levels of fat content in comparison with BMI levels and obesity stages in working patients.

MATERIALS AND METHODS: A cross-sectional, single-center study included 458 working patients observed in the private healthcare institution "KB "RZhD-Medicine" in Yaroslavl. BMI, laboratory blood test results (glucose, uric acid, triglycerides, cholesterol, high-density lipoproteins), data on existing chronic diseases, and a photoplethysmographic marker of insulin resistance were recorded. The obesity stage was determined based on the presence/absence of fasting hyperglycemia, hypertriglyceridemia, decreased HDL-C, and comorbidity data. Statistical processing of the results was performed using the Statistica13 program.

RESULTS: Assessment of obesity by ABCD stages demonstrated the prevalence of metabolically unhealthy obesity (OB stages 1 and 2) in 64.8% of patients (OB1 — in 40.8% of subjects and OB 2 — 24.0%). HU occurs in metabolically unhealthy obesity more often at the second stage than at the first in men by 2.2 times, in women by 2.7 times, and relative to individuals with normal body weight, this ratio is 5.6 and 9.04 times. Photoplethysmographic marker of insulin resistance increased from the group with normal body weight to OB stage 2. Pathological level of photoplethysmographic marker of insulin resistance in men with OB stage 2 was detected more often by 1.4 times compared to OB 0 and by 2.25 times relative to OB stage 1, in women — by 2.2 and 2.1 times, respectively.

CONCLUSION: Metabolically neutral accumulation of fat mass (overweight and obesity stage 0) is very rare in the modern population of outpatient working patients (5.4–3.35%, respectively). Surrogate markers of insulin resistance are determined even with metabolically neutral variants of excess adipose tissue accumulation and reach a prevalence of more than 50% in stage 2 obesity. Hyperuricemia is practically not found in metabolically neutral variants of excess body fat and can act as a cheap routine marker of metabolic distress and a criterion for the effectiveness of preventive interventions.

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