Abstract
Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease that is associated with high serum uric acid (SUA) levels, although the effects of high SUA levels on NAFLD remission remain unclear. In addition, it is unclear whether obesity and high SUA levels have a combined effect on NAFLD remission. This retrospective cohort study evaluated male employees of seven Chinese companies and investigated the association between high SUA levels and NAFLD remission, as well as the potential combined effect of high SUA levels and obesity on NAFLD remission. The study followed 826 men with NAFLD for 4 years, and the NAFLD remission rate was 23.2% (192/826). Comparing to obese and non-obese individuals with normouricemia, individuals with hyperuricemia had significant higher values for total cholesterol, triglycerides, creatinine, and aspartate transaminase (all P < 0.05). Among non-obese individuals, hyperuricemia was associated with a lower NAFLD remission rate, compared to normouricemia (P < 0.001). However, no significant difference was observed between hyperuricemia and normouricemia among obese subjects (P > 0.05). Similar results were observed in the multivariate cox proportional hazard regression analyses. Compared to the normouricemia subjects, individuals with hyperuricemia had a significant lower likelihood of NAFLD remission (RR = 0.535, 95% CI: 0.312–0.916); and obese subjects had a significant lower likelihood of NAFLD remission than the non-obese individuals (RR = 0.635, 95% CI: 0.439–0.918). In addition, the interaction between hyperuricemia and obesity had a statistically significant effect on NAFLD remission (P = 0.048). In conclusion, hyperuricemia and obesity may be involved in NAFLD development and remission, with similar pathogenic mechanisms. Further studies are needed to confirm our findings and determine how to improve these individuals’ conditions.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in Western and Asian countries, and approximately 20 million Chinese individuals (15% of the population) have NAFLD [1]
In 2002, a small Italian study revealed that serum uric acid (SUA) was closely associated with NAFLD [8], and subsequent evidence from three cohort studies [9,10,11] and two meta-analyses [12, 13] have confirmed that high SUA levels are independently associated with the development of NAFLD
As approximately 80% of individuals with NAFLD are male [24], the present study evaluated Chinese men to confirm the association between high SUA levels and NAFLD remission, and to explore the potentially interactive effect of high SUA levels and obesity on NAFLD remission
Summary
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease in Western and Asian countries, and approximately 20 million Chinese individuals (15% of the population) have NAFLD [1]. Serum uric acid (SUA) is the end product of purine metabolism in the human body [5], as the endogenous precursors (nucleoproteins originating from cellular metabolism) and exogenous dietary precursors are delivered to the liver and subsequently excreted by the kidneys and intestine. Any disruption in this process can lead to high SUA levels [6, 7]. Additional evidence is needed to confirm the relationship between high SUA levels and NAFLD remission
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