Effect of body mass index on serum urate and renal uric acid handling responses to an oral inosine load: experimental intervention study in healthy volunteers.
Effect of body mass index on serum urate and renal uric acid handling responses to an oral inosine load: experimental intervention study in healthy volunteers.
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体重指数对口服肌苷负荷下血清尿酸和肾尿酸处理反应的影响：健康志愿者的实验性干预研究
DOI：
10.1186/s13075-020-02357-y
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发表时间：
2020-11-04
影响因子：
4.9
通讯作者：
Merriman TR
中科院分区：
文献类型：
--
作者：
Dalbeth N;Allan J;Gamble GD;Horne A;Woodward OM;Stamp LK;Merriman TR
高身体质量指数（BMI）与高尿酸血症密切相关。目前尚不清楚超重和肥胖是否主要通过增加尿酸生成或减少肾脏对尿酸的清除来影响血清尿酸。本研究的目的是确定BMI对肌苷反应的影响，肌苷是一种嘌呤核苷，在嘌呤回收和降解途径中起中间作用。在禁食一夜之后，100名没有痛风的健康参与者参加了研究访问。在服用1.5 g肌苷前和服用后180分钟内分别取血样和尿样。按BMI高（≥25 kg/m2）组和BMI低/正常（< 25 kg/m2）组，并以BMI为连续变量，分析血清尿酸和尿酸分数排泄（FEUA）。高BMI组（n = 52，平均BMI为30.8 kg/m2）的参与者在基线时血清尿酸浓度高于低/正常BMI组（平均BMI为21.8 kg/m2） （P = 0.002）。然而，高BMI组在肌苷负荷后血清尿酸升高较小（P = 0.0012）。两个BMI组在基线时的FEUA相似（P = 0.995），但高BMI组在肌苷后的FEUA增加较小（P = 0.0003）。当将BMI作为一个连续变量进行分析时，也观察到类似的结果。与BMI低的患者相比，BMI高的患者FEUA /血清尿酸升高的幅度较小（P = 0.005）。在空腹状态下，BMI高的人血清尿酸水平升高，但与BMI低/正常的人相比，FEUA值相似。嘌呤负荷后，BMI高的人尿酸的肾脏排泄减少。这些数据，使用实验方法动态评估人体尿酸处理，表明高BMI的人在禁食和饮食摄入嘌呤后，肾脏尿酸再吸收能力更高，肾脏清除率降低。澳大利亚和新西兰临床试验注册中心（ACTRN12615001302549），注册日期为2015年11月30日。
High body mass index (BMI) is strongly associated with hyperuricaemia. It is unknown whether overweight and obesity influences serum urate primarily through increased urate production or reduced renal clearance of uric acid. The aim of this study was to determine the influence of BMI on the response to inosine, a purine nucleoside that functions as an intermediate in the purine salvage and degradation pathways. Following an overnight fast, 100 healthy participants without gout attended a study visit. Blood and urine samples were taken prior to and over 180 min after 1.5 g oral inosine. Serum urate and fractional excretion of uric acid (FEUA) were analysed according to high BMI (≥ 25 kg/m2) and low/normal BMI (< 25 kg/m2) groups, and according to BMI as a continuous variable. Participants in the high BMI group (n = 52, mean BMI 30.8 kg/m2) had higher serum urate concentrations at baseline (P = 0.002) compared to those with low/normal BMI (mean BMI 21.8 kg/m2). However, the high BMI group had a smaller increase in serum urate following the inosine load (P = 0.0012). The two BMI groups had a similar FEUA at baseline (P = 0.995), but those in the high BMI group had a smaller increase in FEUA following the inosine (P = 0.0003). Similar findings were observed when analysing BMI as a continuous variable. Those with high BMI had a smaller increase in FEUA per increase in serum urate, compared to those with low BMI (P = 0.005). In a fasting state, people with high BMI have elevated serum urate levels but similar FEUA values compared with those with low/normal BMI. Following a purine load, those with high BMI have an attenuated renal excretion of uric acid. These data, using an experimental method to dynamically assess human urate handling, suggest that people with high BMI have a higher renal capacity for uric acid reabsorption when fasted and following a dietary purine intake have reduced renal clearance. Australia and New Zealand Clinical Trials Registry, ACTRN12615001302549, date of registration 30 November 2015.
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影响因子：
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通讯作者：
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作者：
Dalbeth N;Phipps-Green A;House ME;Gamble GD;Horne A;Stamp LK;Merriman TR
通讯作者：
Merriman TR