Abstract
Objective
Experimental and observational studies suggest a role for uric acid in non-alcoholic
fatty liver disease (NAFLD). We examined the association between serum uric acid levels
and NAFLD in a large population-based study from the United States.
Materials/Methods
A cross-sectional analysis of 10,732 nondiabetic adults who participated in the National
Health and Nutrition Examination Survey 1988–1994. Sex specific uric acid quartiles
were defined: ≤5.2, 5.3–6.0, 6.1–6.9, and >6.9 mg/dL for men and ≤3.7, 3.8–4.5, 4.6–5.3, and >5.3 mg/dL for women. NAFLD presence and severity were defined by ultrasonographic detection
of steatosis in the absence of other liver diseases. We modeled the probability that
more severe NAFLD would be associated with the highest quartiles of uric acid.
Results
Compared to the 1st quartile, the odds ratio for NAFLD was 1.79 (95% C.I. 1.49–2.15,
p<0.001) and 3.14 (95% C.I. 2.63–3.75, p<0.001) for the 3rd and 4th quartiles, respectively. After adjusting for demographics,
hypertension, waist circumference, triglycerides, high-density lipoprotein-cholesterol,
homeostasis model assessment-estimated insulin resistance, estimated glomerular filtration
rate, and aspartate aminotransferase, uric acid (4th quartile) was significantly associated
with NAFLD (odds ratio 1.43; 95% C.I. 1.16–1.76, p<0.001). Positive parameter estimates suggest increasing uric acid is associated with
greater severity of NAFLD.
Conclusions
Elevated uric acid level is independently associated with ultrasound-diagnosed NAFLD
in a nationally representative sample of United States nondiabetic adults. Increasing
uric acid is associated with increasing severity of NAFLD on ultrasonography. These
findings warrant further studies on the role of uric acid in NAFLD.
Abbreviations:
NAFLD (non-alcoholic fatty liver disease), NASH (non-alcoholic steatohepatitis), NHANES (National Health and Nutrition Examination Survey), HDL-C (high density lipoprotein cholesterol), eGFR (estimated glomerular filtration rate), HOMA-IR (homeostasis model assessment of insulin resistance), AST (aspartate aminotransferase), ALT (alanine aminotransferase), MDRD (Modification of Diet in Renal Disease), OR (odds ratio), C.I. (confidence interval)Keywords
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Article info
Publication history
Published online: October 04, 2012
Accepted:
August 24,
2012
Received:
March 19,
2012
Identification
Copyright
Published by Elsevier Inc.
