Benefits of bariatric surgery in hyperuricemia management

Hyperuricemia is strongly associated with obesity, and its prevalence has risen with modern lifestyle and dietary changes. Bariatric surgery, widely recognized for treating morbid obesity, also benefits patients with hyperuricemia and gout by reducing serum uric acid (SUA) levels. However, fluctuations in SUA and acute gout attacks soon after surgery are common concerns, and preventive strategies need further research. 

The aim of a new narrative review was to examine bariatric surgery’s role in managing hyperuricemia in obese individuals––summarizing both short- and long-term outcomes, as well as common adverse reactions. The study also explored preoperative and postoperative interventions to offer insights for preventing related complications.

Hyperuricemia, characterized by elevated SUA levels, can lead to gout and kidney issues, posing a global health challenge. Bariatric surgery has been shown to improve hyperuricemia and other metabolic conditions in obese patients. However, gout attacks often occur post-surgery due to rapid changes in SUA. Management strategies include medications such as NSAIDs, colchicine, and corticosteroids, but lifestyle modifications and diet remain crucial. 

Bariatric surgery induces weight loss and alters gastrointestinal physiology, impacting metabolism. Its outcomes are distinct from those of pharmacological treatments because it can maintain long-term weight reduction and significantly improve obesity-related conditions. Hyperuricemia often does not respond well to medication, making bariatric surgery a valuable treatment option. The review evaluates the surgery’s effects on hyperuricemia, highlighting clinical benefits and offering guidelines for managing early postoperative complications.

Further, genetic factors like the ESR1 gene may influence how patients respond to bariatric surgery – highlighting the need for personalized treatment approaches. Long-term follow-up and further research are necessary to enhance outcomes for hyperuricemia management post-surgery.

Source: Song K, Kong X, Yu Z, et al. BMC Surgery. 2024 Aug 21;24(1):235.