Cardiometabolic Risks and Obesity in the Young

We strongly agree with Skinner et al. that overweight is an important promoter of independent risk factors for cardiovascular disease from early childhood. However, we would like to emphasize the additional independent role of emerging risk factors for cardiovascular and chronic kidney disease, such as high plasma levels of uric acid. Hyperuricemia has been reported in overweight children with a significant association with the metabolic syndrome.1 An association between childhood plasma uric acid levels and adult blood pressure was described in the Bogalusa Heart Study,2 and abnormal plasma uric acid levels may be used to discriminate between healthy and unhealthy obese children.3 Finally, an improvement in the plasma uric acid levels may improve body weight and related cardiovascular risk factors in young patients with hyperuricemia.4 Thus, we would suggest that plasma uric acid levels require more attention in the evaluation of the metabolic risk profile of children and adolescents.