OBJECTIVE To evaluate the association between high uric acid (UA), reduced estimated glomerular filtration rate (eGFR), and non-alcoholic fatty liver disease (NAFLD) in outpatient children and adolescents with overweight (OW) or obesity (OB). METHODS Anthropometric, biochemical, hepatic ultrasound and eGFR data were available from 2565 young people with OW/OB (age 5-18 years). eGFR was calculated using the Schwartz's bedside formula and reduced eGFR (ReGFR+) was defined by a value < 90 mL/min/1.73 m2. High UA was defined as ≥ 75th percentile by sex in children and adolescents. RESULTS The population was stratified in four categories: (1) normal eGFR and absence of NAFLD (ReGFR-/NAFLD-) (n = 1,236); (2) ReGFR+ and absence of NAFLD (ReGFR+/NAFLD- (n = 155); (3) normal eGFR and presence of NAFLD (ReGFR-/NAFLD+) (n = 1019); (4) presence of both conditions (ReGFR+/NAFLD+) (n = 155). Proportions of youth with high UA across the four categories were 17%, 30%, 33% and 46%, respectively (P < 0.0001). Young people with high levels of UA had odds ratio (95% CI) of 2.11 (1.43-3.11) for ReGFR+; 2.82 (2.26-3.45) for NAFLD+; and 5.04 (3.45-7.39) for both conditions (P < 0.0001 for all), independently of major confounders. CONCLUSIONS High levels of UA were independently associated with ReGFR, NAFLD and the combination of both conditions in young people with OW/OB. The strength of this association was the highest in cases presenting both reduced eGFR and NAFLD. UA may serve as marker to identify patients at risk for these conditions.

中文翻译：

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肥胖年轻人的高尿酸、肾小球滤过率降低和非酒精性脂肪肝。

目的 评估超重 (OW) 或肥胖 (OB) 门诊儿童和青少年的高尿酸 (UA)、估计肾小球滤过率 (eGFR) 降低和非酒精性脂肪肝 (NAFLD) 之间的关系。方法 人体测量、生化、肝脏超声和 eGFR 数据来自 2565 名 OW/OB 的年轻人（年龄 5-18 岁）。eGFR 使用 Schwartz 的床边公式计算，降低的 eGFR (ReGFR+) 定义为 < 90 mL/min/1.73 m2。高 UA 被定义为儿童和青少年中 ≥ 75% 的性别。结果 将人群分为四类：（1）eGFR 正常且无 NAFLD（ReGFR-/NAFLD-）（n = 1,236）；(2) ReGFR+ 和不存在 NAFLD (ReGFR+/NAFLD- (n = 155)；(3) 正常 eGFR 和存在 NAFLD (ReGFR-/NAFLD+) (n = 1019)；(4) 两种情况都存在 (ReGFR+/NAFLD+) (n = 155)。四个类别中高尿酸的青年比例分别为 17%、30%、33% 和 46%（P < 0.0001）。UA 水平高的年轻人 ReGFR+ 的优势比 (95% CI) 为 2.11 (1.43-3.11)；NAFLD+ 为 2.82 (2.26-3.45)；和 5.04 (3.45-7.39) 两种情况（所有 P < 0.0001），独立于主要混杂因素。结论 高水平的 UA 与年轻 OW/OB 患者的 ReGFR、NAFLD 和这两种情况的结合独立相关。这种关联的强度在 eGFR 和 NAFLD 均降低的病例中最高。UA 可以作为标记来识别有这些疾病风险的患者。分别（P < 0.0001）。UA 水平高的年轻人 ReGFR+ 的优势比 (95% CI) 为 2.11 (1.43-3.11)；NAFLD+ 为 2.82 (2.26-3.45)；和 5.04 (3.45-7.39) 两种情况（所有 P < 0.0001），独立于主要混杂因素。结论 高水平的 UA 与年轻 OW/OB 患者的 ReGFR、NAFLD 和这两种情况的结合独立相关。这种关联的强度在 eGFR 和 NAFLD 均降低的病例中最高。UA 可以作为标记来识别有这些疾病风险的患者。分别（P < 0.0001）。UA 水平高的年轻人 ReGFR+ 的优势比 (95% CI) 为 2.11 (1.43-3.11)；NAFLD+ 为 2.82 (2.26-3.45)；和 5.04 (3.45-7.39) 两种情况（所有 P < 0.0001），独立于主要混杂因素。结论 高水平的 UA 与年轻 OW/OB 患者的 ReGFR、NAFLD 和这两种情况的结合独立相关。这种关联的强度在 eGFR 和 NAFLD 均降低的病例中最高。UA 可以作为标记来识别有这些疾病风险的患者。结论 高水平的 UA 与年轻 OW/OB 患者的 ReGFR、NAFLD 和这两种情况的结合独立相关。这种关联的强度在 eGFR 和 NAFLD 均降低的病例中最高。UA 可以作为标记来识别有这些疾病风险的患者。结论 高水平的 UA 与年轻 OW/OB 患者的 ReGFR、NAFLD 和这两种情况的结合独立相关。这种关联的强度在 eGFR 和 NAFLD 均降低的病例中最高。UA 可以作为标记来识别有这些疾病风险的患者。