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7 DETERMINANTS OF SERUM URATE IN ADOLESCENCE

During adolescence, serum uric acid concentration increases and adult levels are attained. Physiologic factors related to adolescent serum urate levels were investigated using data from the U.S. Health Examination Survey. The survey population comprised 6768 youths, aged 12 to 17 years, selected to represent the U.S. population with respect to age, sex, race, and demographic status. Serum urate increases markedly during pubescence in males; in females the increase is modest. In males, the increase is strongly associated with sexual maturation (Tanner staging) and with skeletal age (radiographic assessment). The relationships among skeletal age, serum urate, and Tanner stage in males are strong enough to permit use of urate concentration in assessing sexual and physiological maturation. In later adolescence, body composition (body mass index and skinfold thickness), and hematocrit are more closely related to serum urate than is sexual maturation. Blood pressure and serum cholesterol have significant but weaker relationships. These relationships are similar to those in adults. Serum urate concentrations are 0.5 mg/dl lower in black male and female youths of all ages, and this consistent difference is unrelated to other factors. During adolescence, the early rise in serum urate concentration is related to physiological maturation, while the levels in late adolescence are similar to those in adults.