Prevalence of hyperuricemia and its associations with hyperinsulinemia and hepatic injury among adolescents with obesity in Guangxi, China.

OBJECTIVE: To investigate the prevalence of hyperuricemia (HUA) in adolescents with obesity in Guangxi, southern China, and explore its associations with hyperinsulinemia and hepatic injury. METHODS: A total of 200 adolescents with obesity aged 10-18 years who visited the Children and Adolescents Weight Management Center of Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region from May to December 2025 were enrolled. According to the Clinical Practice Consensus Statement 2025: Management of Hyperuricemia and Gout in Adolescents (fasting serum uric acid ≥ 420 μmol/L for HUA), the subjects were divided into non-HUA and HUA groups. Anthropometric and fasting laboratory indicators were collected. Univariate analyses, multivariate logistic regression, and unadjusted restricted cubic spline (RCS) models were applied for statistical analyses. RESULTS: The prevalence of HUA was 44.50% (89/200), with 47.59% (69/145) in males and 36.36% (20/55) in females. Univariate analysis showed significant between-group differences in age, body mass index z-score (BMIZ), low-density lipoprotein cholesterol (LDL-C), fasting insulin, alanine aminotransferase (ALT), dyslipidemia, and hyperinsulinemia (all P < 0.05). Multivariate logistic regression revealed that age > 12 years (OR = 2.60, 95%CI:1.19-5.68, P = 0.017), hyperinsulinemia (OR = 2.33, 95%CI:1.11-4.92, P = 0.026) and abnormal ALT (OR = 2.44, 95%CI:1.02-5.87, P = 0.046) were independent risk factors for HUA. Restricted cubic spline models revealed positive dose-response relationships between age, fasting insulin, ALT, BMIZ and the risk of HUA (all P for overall < 0.05). CONCLUSION: HUA is highly prevalent among adolescents with obesity in Guangxi. Older age, hyperinsulinemia, and elevated ALT are independently associated with HUA risk. These findings highlight the importance of comprehensive metabolic management, including insulin sensitivity and liver function assessment, in this high-risk population.