Abstract
Objective The present study aimed to explore the association between SUA and NAFLD in women with different menstrual statuses. Methods A total of 6043 women were selected from the Jidong and Kailuan communities for inclusion in the present study. The SUA levels of participants were divided into quartiles. NAFLD was determined by abdominal ultrasonography. Data from laboratory tests and clinical examination were collected, and basic information was obtained from standardized questionnaires. The menstrual status was stratified into menstrual period, menopause transition period, and postmenopause. Multivariate logistic regression models were used to determine the relationship between menstrual status, SUA, and NAFLD. Results The levels of SUA in subjects with NAFLD in the menstrual period, menopause transition period, and postmenopause were 268.0 ± 71.1, 265.6 ± 67.8, and 286.7 ± 75.8 (mmol/L), respectively, and were higher than those in subjects without NAFLD. The adjusted odds ratios (ORs) with 95% confidence interval (CI) for NAFLD among participants in the menopause transition period and postmenopausal period were 1.10 (0.89–1.37) and 1.28 (1.04–1.58), respectively, compared with the menstrual period women. Compared to the lowest quartile of SUA, the adjusted ORs with 95% CI of the highest quartile for NAFLD were 2.24 (1.69–2.99) for females in the menstrual period, 1.92 (1.10–3.37) for females in the menopause transition period, and 1.47 (1.06–2.03) for females in postmenopause. Conclusions Menstrual status was significantly correlated with NAFLD. High levels of SUA were associated with NAFLD in females during the three menstrual periods.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, which has become an important public health issue [1]
Discussion e present study showed that SUA and menstrual status were associated with NAFLD in women. e prevalence of NAFLD progressively increased from the lowest quartile to the highest quartile of SUA. e risk of NAFLD increased approximately 40% and 80% in the third and fourth quartiles of SUA, respectively, after adjusting for potential confounding factors in all women
Li et al found that elevated SUA was an independent risk factor for NAFLD [7]. e concentrations of SUA were demonstrated to be inversely associated with NAFLD remission in males [23]. e SUA was implied to independently predict an increased risk for NAFLD in a prospective study [24]
Summary
Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, which has become an important public health issue [1]. Evidence has implied that the prevalence of NAFLD is higher in men than in women, but other studies indicated that it was higher in women than in men [2]. The prevalence of NAFLD was up to approximately 40%, which suggested a greater importance of NAFLD for postmenopausal women [6]. 186 participants excluded due to incomplete examination of NAFLD, SUA, and important confounders. 264 participants excluded due to taking hormone drugs, a history of menopause caused by surgery and medications, alcohol consumption, viral, or autoimmune liver disease. A total of 6043 women included in the final analysis The prevalence of NAFLD was up to approximately 40%, which suggested a greater importance of NAFLD for postmenopausal women [6]. e development of NAFLD is closely correlated with several chronic diseases, such as obesity, type 2 diabetes mellitus, dyslipidemia, and hypertension, which are components of metabolic syndrome (MetS) [7,8,9]. ese involve the interaction among several signaling pathways. ese include inflammation, oxidative stress, hepatocyte apoptosis, and insulin resistance associated
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