Endocrine Abstracts

Introduction

Facing the repeated failures of the medical management of obesity, bariatric surgery offers a promising therapeutic option in terms of achieving weight loss and metabolic benefits. Our study aimed to assess the impact of sleeve gastrectomy on uric acid metabolism in obese subjects.

Methods

This was a repeated retrospective cross-sectional study including 40 obese patients who were followed up at the Research Unit on Obesity at the National Institute of Nutrition and Food Technology in Tunis up to 12 months after sleeve gastrectomy. The preoperative clinical and biological data and those checked at six and 12 months after surgery were collected from the patients’ medical records.

Results

The mean patients’ age was 34.65 ± 8.17 years and the sex-ratio was 0.21. The mean body mass index (BMI) was 50.23 ± 8.3 kg/m². The average uricemia was 325.3 91.6 µmol/l. The frequency of hyperuricemia in our population was 7%. After sleeve gastrectomy, the mean excess weight loss was 55.8% at 12 months. Uric acid levels decreased in patients with initial hyperuricemia. The hyperuricemia remission was observed in two out of three patients. However, we noted an improvement of the uric acid level in the patient who retained this abnormality. For patients who did not initially suffer from hyperuricemia, we saw an insignificant increase in uricemia, six months after the sleeve gastrectomy. Indeed, three patients developed this abnormality at six months post-operative. This was followed by a significant decrease in uric acid levels one year after the intervention.

Discussion

After bariatric surgery, weight loss would decrease uric acid levels, on the one hand, by reducing the production of urate and on the other hand, by increasing urate renal excretion following insulin sensibility enhancement since urate renal clearance has an inverse relationship to insulin resistance [1]. Referencet

1. Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin-mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 4 déc 1991;266(21):3008–11.