ArticleBMC surgery2025
Short-term dynamics of serum uric acid and its influencing factors in patients with obesity after laparoscopic sleeve gastrectomy.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe pathophysiological association between obesity and hyperuricemia (HUA) is well-established. Metabolic and bariatric surgery (MBS) has been shown to effectively manage severe obesity and lead to sustained reductions in serum uric acid (SUA) over the long term; however, the factors modulating short-term fluctuations in SUA (i.e., within 6 months postoperatively) and their underlying mechanisms remain poorly elucidated.
methodsWe performed a retrospective analysis of data from 184 patients with obesity who underwent laparoscopic sleeve gastrectomy (LSG). Clinical data were retrieved at baseline, on postoperative day 1, and at 1, 3, and 6 months postoperatively. Per established guidelines, patients were stratified into a normal SUA (NUA) group (n = 74) and an elevated SUA (EUA) group (n = 110).
resultsAge, baseline estimated glomerular filtration rate (eGFR₀), baseline SUA (SUA₀), 1-month postoperative change in eGFR (Δ₁ₘ-eGFR), and 1-month postoperative change in BMI (Δ₁ₘ-BMI) were independent predictors of 1-month postoperative change in SUA (Δ₁ₘ-SUA). Age, sex, SUA₀, baseline triglyceride-glucose index (TyG₀), eGFR₀, 6-month postoperative change in eGFR (Δ₆ₘ-eGFR), 6-month postoperative change in total protein (Δ₆ₘ-TP), and 6-month postoperative change in TyG (Δ₆ₘ-TyG) were independent predictors of 6-month postoperative SUA (SUA₆ₘ). Process-mediated mediation analysis revealed that the effect of baseline BMI (BMI₀) on Δ₁ₘ-SUA was fully mediated by Δ₁ₘ-BMI; the effect of eGFR₀ on Δ₁ₘ-SUA was partially mediated by Δ₁ₘ-eGFR, while the effect of eGFR₀ on SUA₆ₘ was fully mediated by Δ₆ₘ-eGFR. In the EUA group, 3-month postoperative SUA (SUA₃ₘ) was significantly lower than the baseline value. In the NUA group, SUA at 1, 3, and 6 months postoperatively (SUA₁ₘ/SUA₃ₘ/SUA₆ₘ) remained significantly higher than the baseline value, with a more pronounced increase in Δ₆ₘ-eGFR noted in males compared to females.
conclusionΔ₁ₘ-BMI is a key determinant of Δ₁ₘ-SUA. Patients with Δ₁ₘ-BMI ≥ 4.25 kg/m2 warrant weekly SUA monitoring during the first month postoperatively. Prompt clinical intervention is necessary when SUA exceeds 535.5 μmol/L, especially in patients with a history of gout. For patients with baseline impaired renal function (eGFR: 60–89 mL/min/1.73m2), preoperative optimization of renal reserve is recommended; those with renal hyperfiltration (eGFR > 125 mL/min/1.73m2) require intensified postoperative monitoring of eGFR and SUA. Males in the NUA group are at an increased risk of SUA elevation at 6 months postoperatively. Furthermore, age and SUA₀ are independent predictors of Δ₁ₘ-SUA, while age, sex, SUA₀, TyG₀, Δ₆ₘ-TP, and Δ₆ₘ-TyG are independent predictors of SUA₆ₘ.
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