Association between Serum Uric Acid and Nonalcoholic Fatty Liver Disease in Nonobese Postmenopausal Women: A Cross-sectional Study

Ting Bao,Xianweng Jiang,Zhengzheng Li,Hanwei Yang,Li Gong,Jing Du,Zhiye Ying,Yan Huang,Huairong Tang,Guiyi Ji,Wei Gao

doi:10.1038/s41598-020-66931-9

Abstract

This study aimed to determine the association between serum uric acid (sUA) and nonalcoholic fatty liver disease (NAFLD) in nonobese postmenopausal women. A total of 4323 female individuals over 18 years of age participated in this cross-sectional study. The subjects were divided into four groups according to menopause status and body mass index. sUA quartiles in this female population were categorized as follows: Q1 ≤ 230 mmol/L, Q2: 231–270 mmol/L, Q3: 271–310 mmol/L and Q4: ≥ 311 mmol/L. The presence or absence of NAFLD was assessed by abdominal ultrasonography. The prevalence of NAFLD was 38.8% in the general population, and the average age was 46.5 ± 11.3 years. Among nonobese and obese subjects, the prevalence of NAFLD was lower in nonmenopausal subjects than in postmenopausal subjects (nonobese: 20.74% vs 45.26%, respectively, P < 0.0001; obese: 70.51% vs 84.35%, respectively, P < 0.0001). After adjusting for age, current smoking status, current alcohol drinking status, diabetes, hypertension disease and triglyceride, the ORs (95% CIs) for NAFLD among individuals in Q2-Q4 were 1.518 (1.062–2.169), 1.431 (1.010–2.027) and 2.054 (1.442–2.927), respectively, P value for trend <0.0001. Higher sUA levels can be used as a predictive biomarker for NAFLD in nonobese postmenopausal women.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is recognized as a major cause of liver disease worldwide[1]
A large number of studies have indicated that the association between serum uric acid (sUA) and nonalcoholic fatty liver disease (NAFLD) is significantly greater in females than in males[11,12]
It is necessary to identify the natural course of NAFLD and the factors contributing to the development of NAFLD in nonobese postmenopausal female populations, as well as to evaluate whether there are differences in the risk factors for NAFLD among sUA levels in nonobese and obese postmenopausal female populations

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is recognized as a major cause of liver disease worldwide[1]. The prevalence of NAFLD in the general population of China is 25–31%6,7. A large number of studies have indicated that the association between sUA and NAFLD is significantly greater in females than in males[11,12]. Growing evidence suggests that the NAFLD-sUA relation is present in obese populations[13,14,15], few studies have demonstrated this relationship in nonobese postmenopausal women. In China, where the population is generally less obese, the prevalence of NAFLD are increasing[7]. We first determined the prevalence of NAFLD in groups according to the sUA quartiles and the prevalence of NAFLD in nonobese and obese female populations according to the menopause status. We investigated whether the risk factors for NAFLD varied among the sUA quartiles. (Table 1)

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Results

Conclusion