Ghrelin and Leptin among Patients with Urolithiasis with Concomitant Hyperuricemia and Metabolic Syndrome.

Introduction: The study evaluated the selected appetite hormones (ghrelin, leptin) and inflammatory parameters (tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6)) in patients with urolithiasis, metabolic syndrome (MetS), and hyperuricemia. Materials: 57 patients with urolithiasis, MetS and hyperuricemia (UP group) and 29 healthy people as the control group (CG group) were recruited to the study. All persons were 22-60 age. Methods: After preliminary testing, the qualified participants were evaluated for fasting serum levels of ghrelin, leptin, IL-6, and TNF-α. Results: Our results revealed differences between average values of leptin (p = 0.045), ghrelin (p < 0.001), IL-6 (p < 0.001), and TNF-α (p < 0.001) in the studied groups. Moreover, in the UP group, significant correlations were found between ghrelin and leptin; between these hormones and IL-6, and between leptin and uric acid (UA). Besides, leptin concentration increased significantly along with the changes in the body mass index (BMI) categories in the UP group. Conclusions: This study showed that patients with urolithiasis, concomitant MetS, and high UA levels may have problems managing appetite hormones.

High-Fructose Diet-Induced Hyperuricemia Accompanying Metabolic Syndrome-Mechanisms and Dietary Therapy Proposals.

Fructose is often used as a food ingredient due to its low production costs and sweetening power. In recent years, it has been noticed that people on a Western diet high in fructose have high levels of uric acid in their blood. It was recognized that the specific metabolism of fructose in the body might cause increased production of uric acid, which then may affect the intensification of lipogenesis and the development of metabolic syndrome (MetS), insulin resistance, gout, cardiovascular diseases, leptin resistance, or non-alcoholic fatty liver disease. So far, to treat hyperuricemia, it has been recommended to use a low-purine diet characterized by limiting protein-containing products. However, this recommendation often leads to an increased intake of carbohydrate-rich foods that may contain fructose. Increased fructose consumption may enhance the secretion of uric acid again and, consequently, does not have therapeutic effects. Therefore, instead of a low-purine diet, using healthy diets, such as DASH or the Mediterranean diet, which can benefit metabolic parameters, could be a better proposal. This article provides an overview of this approach, focusing on MetS and hyperuricemia among high-fructose dieters.

Insulin Resistance and Urolithiasis as a Challenge for a Dietitian.

Many obesity and diet-related diseases have been observed in recent years. Insulin resistance (IR), a state of tissue resistance to insulin due to its impaired function, is a common coexisting condition. The most important predisposing factors are excessive visceral fat and chronic low-grade inflammatory response. However, IR's pathogenesis is not fully understood. Hence, the diagnosis of IR should be carried out carefully because many different diagnostic paths do not always give equivalent results. An additional disease that is often associated with IR is urolithiasis. The common feature of these two conditions is metabolic acidosis and mild inflammation. A patient diagnosed with IR and urolithiasis is a big challenge for a dietitian. It is necessary to check a thorough dietary history, make an appropriate anthropometric measurement, plan a full-fledged diet, and carry out the correct nutritional treatment. It is also essential to conduct proper laboratory diagnostics to plan nutritional treatment, which is often a big challenge for dietitians. The diet's basic assumptions are based on the appropriate selection of carbohydrates, healthy fats, and wholesome protein sources. It is also essential to properly compose meals, prepare them, and plan physical activities tailored to the abilities. The study aims to summarise the necessary information on IR with concomitant urolithiasis, which may be helpful in dietary practice.