Laparoscopic Sleeve Gastrectomy Improves Serum Uric Acid Levels and Has Sex Difference in Severely Obese Patients

Introduction: Hyperuricemia (HUA) is associated with multiple metabolic comorbidities. Recent evidence has shown that bariatric surgery may improve major comorbidities including HUA. We aimed to investigate changes of serum uric acid (sUA) and other biomarker parameters in severely obese patients after laparoscopic sleeve gastrectomy (LSG) over a 1-year period.

Methods: A prospective follow-up study of 12 months was conducted with 133 obese patients undergoing LSG. Patients were divided into two groups: normal sUA (NUA) group and HUA group. sUA and relevant metabolic parameters were compared pre and post operation.

Results: At baseline, sUA levels and prevalence of HUA were significantly higher in males than females. Patients with HUA tended to have a worsening metabolic status. After surgery, sUA levels did not exhibit statistically significant changes in NUA group. In HUA group, females showed significantly decreased sUA levels from 3 to 12 months, while in males, sUA significantly increased at 1- and 3-month but decreased at 6- and 12-month after LSG. For HUA patients, we observed gradual reduction in the occurrence of HUA and increase in the resolution rates of HUA, and changes in sUA levels were significantly higher in females than males. Decreased sUA levels correlated significantly with decreased BMI, fasting insulin and HOMA-IR in females, and BMI and HOMA-IR in males.

Conclusion: The sUA levels and rate of HUA were significantly higher in males than females. LSG appears to be effective in reducing sUA levels and occurrence of HUA in patients with HUA prior to the operation, which exhibited earlier and more favorable for female patients. Reduced sUA levels may be potentially mediated by substantial weight loss and improved insulin resistance.