URATE CHANGES IN LEAN AND OBESE BOYS DURING PUBERTAL DEVELOPMENT

Uric acid metabolism is not uniform throughout puberty. Serum urate in creases progressively in obese boys as puberty advances, but it increa ses significantly only at the end of puberty in lean subjects. Urate f iltered per unit of body weight increases in all subjects at the end o f puberty when fractional excretion is diminished. Urate clearance dec reases at the beginning of puberty in obese boys and at the end of pub erty in lean subjects. Urate excretion corrected for body weight and t he urinary uric acid to creatinine ratio do not change over the course of pubertal development in both lean and obese boys. These results su ggest the following hypotheses: (1) renal retention of urate may repre sent the first mechanism by which uricemia is enhanced at puberty; (2) the kidney may finely modulate serum uric acid concentration through different mechanisms of urate handling, presumably occurring at differ ent tubular sites; and (3) obesity may evoke sooner the urate changes that in lean boys are observed at the end of puberty. (C) 1996 by W.B. Saunders Company