Original Contribution
Gender-dependent impacts of body mass index and moderate alcohol consumption on serum uric acid—an index of oxidant stress status?

https://doi.org/10.1016/j.freeradbiomed.2009.02.002Get rights and content

Abstract

Uric acid seems to be causally involved in a variety of medical disorders involving oxidative stress. Although alcohol abuse and obesity are known to increase serum uric acid, the interactions between moderate drinking, adiposity, and uric acid metabolism have remained poorly understood. We examined serum uric acid concentrations from 2062 apparently healthy volunteers (970 men, 1092 women) reporting either no alcohol (abstainers) or < 40 g of ethanol consumption per day (moderate drinkers). The study population was further classified according to BMI as follows: < 19 (underweight), 19–25 (normal weight), 25–30 (overweight), and > 30 (obese). Serum uric acid concentrations in male moderate drinkers were significantly higher, and in females they were lower, than in the corresponding groups of abstainers. In the BMI-based subgroups, the highest concentrations were found in those who were overweight or obese. Significant two-factor interactions occurred between gender and drinking status (p < 0.001) and between gender and BMI (p < 0.02). Serum uric acid also correlated with indices of hepatocellular health (GGT, ALT, AST). The data indicate distinct gender-dependent impacts of alcohol consumption and BMI on serum uric acid. These findings should be applicable to the assessment of oxidative stress status and associated morbidity in alcohol consumers and individuals with excess body weight.

Section snippets

Study protocol

Subjects in this study were participants in a survey collected for establishing reference intervals for common laboratory parameters in Nordic countries and, therefore, they partially overlap with our previous study on γ-glutamyl transferase (GGT) [15]. Subjects were recruited following the rules of the Nordic Reference Interval project (NORIP protocol) [16]. The study population consisted primarily of hospital personnel and their relatives or acquaintances, of whom 97% were Scandinavians and

Results

Serum uric acid concentrations in male moderate drinkers were significantly higher (p < 0.01), and in female moderate drinkers lower (p < 0.01), than those in the corresponding groups of abstainers (Fig. 1). When the study population was further classified according to BMI, the highest concentrations were found in overweight and obese individuals (Fig. 2). Interestingly, significantly higher uric acid concentrations in male moderate drinkers (335 ± 62 μmol/L) compared to abstainers (313 ± 52 μmol/L)

Discussion

This cross-sectional survey among a large population of apparently healthy abstainers and moderate drinkers indicates distinct gender-dependent impacts of increased body weight and alcohol drinking on serum uric acid, which has recently been closely linked with oxidant stress status in humans [1], [5]. The concentration of serum uric acid is influenced by nitric oxide (NO) and peroxynitrite production and plays a pivotal role in the human antioxidant defense systems through its ability to

Conclusions

This study indicates significant interactions between gender, BMI, alcohol consumption, and serum uric acid, which may be associated with the status of oxidative stress in such individuals. Future population studies addressing the prognostic and clinical implications of such responses and whether it might be necessary to formulate BMI-based recommendations for uric acid normal ranges seem warranted.

Acknowledgments

We are grateful to Professor Pål Rustad, Fürst Medical Laboratory, Oslo, Norway, for providing data from the Nordic NORIP survey on reference intervals.

References (63)

  • D. Modun et al.

    The increase in human plasma antioxidant capacity after red wine consumption is due to both plasma urate and wine polyphenols

    Atherosclerosis

    (2008)
  • O. Niemelä

    Biomarkers in alcoholism

    Clin. Chim. Acta

    (2007)
  • U.M. Khosla et al.

    Hyperuricemia induces endothelial dysfunction

    Kidney Int.

    (2005)
  • L.G. Sanchez-Lozada et al.

    Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats

    Kidney Int.

    (2005)
  • M. Almeida et al.

    Skeletal involution by age-associated oxidative stress and its acceleration by loss of sex steroids

    J. Biol. Chem.

    (2007)
  • R. Wolbold et al.

    Sex is a major determinant of CYP3A4 expression in human liver

    Hepatology

    (2003)
  • C.S. Wingrove et al.

    The effect of menopause on serum uric acid levels in non-obese healthy women

    Metabolism

    (1998)
  • X. Qiao et al.

    Sex steroids and vascular responses in hypertension and aging

    Gend. Med.

    (2008)
  • E.S. Ginsburg

    Estrogen, alcohol and breast cancer risk

    J. Steroid Biochem. Mol. Biol.

    (1999)
  • M.R. Meyer et al.

    Need for research on estrogen receptor function: importance for postmenopausal hormone therapy and atherosclerosis

    Gend. Med.

    (2008)
  • S.F. Kendrick et al.

    A coffee with your brandy, Sir?

    J. Hepatol.

    (2007)
  • C.P. Day

    From fat to inflammation

    Gastroenterology

    (2006)
  • C.E. Ruhl et al.

    Joint effects of body weight and alcohol on elevated serum alanine aminotransferase in the United States population

    Clin. Gastroenterol. Hepatol.

    (2005)
  • P. Alatalo et al.

    Effect of moderate alcohol consumption on liver enzymes increases with increasing body mass index

    Am. J. Clin. Nutr.

    (2008)
  • T. Nakagawa et al.

    A causal role for uric acid in fructose-induced metabolic syndrome

    Am. J. Physiol. Renal Physiol.

    (2006)
  • K.J. Davies et al.

    Uric acid–iron ion complexes: a new aspect of the antioxidant functions of uric acid

    Biochem. J.

    (1986)
  • D. Pitocco et al.

    Hypouricemia linked to an overproduction of nitric oxide is an early marker of oxidative stress in female subjects with type 1 diabetes

    Diabetes Metab. Res. Rev.

    (2008)
  • B. Conway et al.

    Obesity as a disease: no lightweight matter

    Obes. Rev.

    (2004)
  • J. Korner et al.

    The emerging science of body weight regulation and its impact on obesity treatment

    J. Clin. Invest.

    (2003)
  • W.R. Kim et al.

    Serum activity of alanine aminotransferase (ALT) as an indicator of health and disease

    Hepatology

    (2008)
  • S. Zakhari et al.

    Determinants of alcohol use and abuse: impact of quantity and frequency patterns on liver disease

    Hepatology

    (2007)
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