Several investigations have demonstrated that uric acid levels in children and early adolescents who are obese are markedly associated with blood pressure, lipids, insulin resistance and anthropometric parameters.(30,35,40) It was proposed that the level of uric acid could be a predictive factor for unhealthy obesity with metabolic and cardiovascular risk in early adolescents and adults.(41) Although it is likely that hyperuricemia in Down syndrome has a high degree of independence from other parameters, confirmation of this hypothesis warrants further research. Here, INS is linked to hyperuricemia.