Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) has become a serious disease affecting people's health in the world. This article studies the causal relationship between NAFLD and serum uric acid (SUA) levels.Methods: During the 4 years of follow-up in a fixed cohort that was established in 2014, 2,832 follow-up subjects without NAFLD were finally included in this study. The study population was divided into four groups according to baseline SUA levels. Cox hazard regression model and Kaplan–Meier survival curves analysis were used to predict risk factors of NAFLD. The receiver operating characteristic curve analyses were used to determine SUA cutoffs for predicting NAFLD.Results: The cumulative prevalence rates of NAFLD were 33.97% (962/2,832), 38.93% (758/1,947) in males and 23.05% (204/885) in females. The results showed that males had a higher incidence of NAFLD (χ2 = 68.412, P = 0.000). The Cox regression analysis disclosed that the hazard ratios of NAFLD [95% confidence interval (CI)] were 1.431 (95% CI, 1.123~1.823), 1.610 (95% CI, 1.262–2.054), and 1.666 (95% CI, 1.287–2.157) across the second to the fourth quartile of SUA adjusted for other confounders. The SUA cutoffs, sensitivity, specificity, and area under the curve (AUC) (95% CI) were ≥288.5 μmol/L, 75.5, 46.5%, 0.637(0.616–0.658), respectively, for total; ≥319.5 μmol/L, 65.8%, 48.4%, 0.590 (0.564–0.615), respectively, for males; and ≥287.5 μmol/L, 51.0%, 75.6%, 0.662 (0.619–0.704), respectively, for females. Kaplan–Meier survival curves revealed that individuals with higher SUA level had an increased risk of NAFLD in comparison to lower SUA level (P = 0.000).Conclusion: Serum uric acid is positively correlated with NAFLD, and elevated SUA level can be used as an independent predictor for NAFLD.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver disease
The Cox regression analysis disclosed that the hazard ratios of NAFLD [95% confidence interval (CI)] were 1.431, 1.610, and 1.666 across the second to the fourth quartile of Serum uric acid (SUA) adjusted for other confounders
Serum uric acid is positively correlated with NAFLD, and elevated SUA level can be used as an independent predictor for NAFLD
Summary
Non-alcoholic fatty liver disease (NAFLD) is a very common chronic liver disease. The prevalence of NAFLD in the general population ranges from 20 to 30%, but its prevalence in the middle-aged population of Western countries can reach 46%, and 5 to 42% in Asian countries [1,2,3,4,5,6]. As a component of metabolic syndrome (MetS), NAFLD is closely related to obesity, insulin resistance (IR), type 2 diabetes mellitus (T2DM), cardiovascular disease, and other chronic diseases [7, 8]. Numerous studies have suggested that the level of SUA will increase with the development of chronic metabolic diseases such as cardiovascular disease [9, 10], T2DM [11], and MetS [12,13,14]. In a cross-sectional study including 129 children and adolescents, the association between SUA and NAFLD was not observed [18]. A cross-sectional study of 541 patients with type 2 diabetes showed that the association between SUA and NAFLD was found only in males, but not in females [20]. This article studies the causal relationship between NAFLD and serum uric acid (SUA) levels
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