Increased Serum Uric Acid over five years is a Risk Factor for Developing Fatty Liver

Thomas Jensen,Masanari Kuwabara,Gabriela Garcia,Minoru Ohno,Yuka Sato,Carlos A Roncal-Jimenez,Richard J Johnson,Ichiro Hisatome,Miguel A Lanaspa,Koichiro Niwa,Ana Andres-Hernando,Mehmet Kanbay

doi:10.1038/s41598-018-30267-2

Abstract

The prevalence of fatty liver disease (FLD) is increasing. To clarify risk factors for developing FLD, we analyzed a database from healthy Japanese adults who had annual medical check-ups in 2004 and reexamined in 2009. We used the fatty liver index (FLI) to classify participants as FLD (FLI ≥60), borderline FLD (30≤ FLI <60), and normal liver (FLI <30). Subjects with hepatitis B or C virus infection and subjects with FLD at the baseline were excluded. The cumulative incidence of FLD from normal liver and from borderline FLD over five years were 0.65% (52/8,025) and 12.9% (244/1,888), respectively. After multiple adjustments, higher serum uric acid (SUA) (OR:1.92; 95% CI:1.40–2.63) and increased SUA change (OR:3.734; 95% CI:2.57–5.42) became risk factors for developing FLD from normal liver, as well as younger age and higher body mass index. The risk factors for developing FLD from borderline FLD were similar. Not only higher baseline SUA but also increased SUA change became independent risks for developing FLD.

Highlights

Fatty liver disease (FLD) is emerging as the number one cause of chronic liver disease especially in developed countries[1]
The key finding in our study is that, does baseline serum uric acid (SUA) predict the development of fatty liver disease (FLD) in a healthy population independent of several other traditional risk factors, but increased SUA change over 5 years becomes a strong risk for developing FLD
There are many studies that clarified the association between SUA and FLD, but this is the first study that assessed SUA change over 5years as a risk factor for developing FLD

Summary

Introduction

Fatty liver disease (FLD) is emerging as the number one cause of chronic liver disease especially in developed countries[1]. FLD will soon eclipse Hepatitis C as the number one indication for liver transplant[8] Identification of those at risk for FLD is necessary in aiding timely discussions about the disease, screening, and prevention especially through life style modifications. Traditional risk factors such as central obesity, insulin resistance, western diet (high fructose, high fat, high salt), sedentary lifestyle, and genetics are well established as having roles in the development and progression of FLD9. This study checked our hypothesis that a higher SUA at baseline, and increase in SUA over time are risk factors for developing FLD

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Results

Conclusion