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Association between serum uric acid level and non-alcoholic fatty liver disease in Koreans

Huiyul Park
Huiyul Park
, 
Kye-Yeung Park
Kye-Yeung Park
, 
Minki Kim
Minki Kim
, 
Hoon-Ki Park
Hoon-Ki Park
 und 
Hwan-Sik Hwang
Hwan-Sik Hwang
   | 28. Feb. 2022
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Article Category: Original article
Online veröffentlicht: 28. Feb. 2022
Seitenbereich: 15 - 22
DOI: https://doi.org/10.2478/abm-2022-0003
Schlüsselwörter
© 2022 Huiyul Park et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1

Study flow diagram. HbsAg, surface antigen hepatitis B virus; HCV, hepatitis C virus; NAFLD, non-alcoholic fatty liver disease.
Study flow diagram. HbsAg, surface antigen hepatitis B virus; HCV, hepatitis C virus; NAFLD, non-alcoholic fatty liver disease.

Figure 2

Scatter plots for SUA level versus FLI (A), ALT (B), and NFS (C). Histograms of SUA level versus presence of NAFLD (D), abnormal ALT (E), and NFS grade (F). Histogram bars indicate means, error bars indicate standard deviation from the mean. Pearson correlation coefficients and P-values are presented in the scatter plots. Abnormal ALT is defined as a serum ALT level ≥ 40 IU/L. A Student t test (D, E), or ANOVA (F) was used to compare each group. NFS grade 0, advanced fibrosis was excluded; 1, needs further examination; and 2 indicates suspected advanced fibrosis. ALT, serum alanine transferase level (IU/L); ANOVA, analysis of variance; NAFLD, non-alcoholic fatty liver disease; NFS, NAFLD fibrosis score; Uric acid, serum uric acid level.
Scatter plots for SUA level versus FLI (A), ALT (B), and NFS (C). Histograms of SUA level versus presence of NAFLD (D), abnormal ALT (E), and NFS grade (F). Histogram bars indicate means, error bars indicate standard deviation from the mean. Pearson correlation coefficients and P-values are presented in the scatter plots. Abnormal ALT is defined as a serum ALT level ≥ 40 IU/L. A Student t test (D, E), or ANOVA (F) was used to compare each group. NFS grade 0, advanced fibrosis was excluded; 1, needs further examination; and 2 indicates suspected advanced fibrosis. ALT, serum alanine transferase level (IU/L); ANOVA, analysis of variance; NAFLD, non-alcoholic fatty liver disease; NFS, NAFLD fibrosis score; Uric acid, serum uric acid level.

Prevalence of hyperuricemia according to underlying disease

Underlying disease condition Prevalence of hyperuricemia P
NAFLD (−) 76 (12.8) <0.001
NAFLD (+) 181 (24.2)
ALT abnormality (−) 200 (17) <0.001
ALT abnormality (+) 57 (34.5)
HTN (−) 176 (17) <0.001
HTN (+) 81 (26.4)
Liver fibrosis (NFS grade £ 1) 254 (19.1) 0.82
Liver fibrosis (NFS grade =2) 3 (21.4)
Diabetes mellitus (−) 243 (19.3) 0.49
Diabetes mellitus (+) 14 (16.3)

Baseline characteristics, demographic data, and hyperuricemia and metabolic disease prevalence of patients according to presence of NAFLD

Health check-up patients (N = 1,343) Normal patientsn = 596 (44.4) Patients with NAFLDn = 747 (55.6) Hepatic steatosis status P† P for trend
Mild FLn = 435 (32.4) Moderate FLn = 248 (18.5) Severe FLn = 64 (4.7)
Age (years) 44.1 (13.0) 48.9 (10.7) 48.7 (11.2) 49.5 (10.0) 46.8 (10.0) <0.001 <0.001
Male sex, n (%) 265 (44.5) 509 (68.1) 261 (60.0) 196 (79.0) 52 (81.3) <0.001 <0.001
Normal weight (BMI <23) 425 (71.3) 183 (24.5) 151 (34.7) 30 (12.1) 2 (3.1)
Overweight (BMI ≥23, <25) 119 (20.0) 236 (31.6) 155 (35.6) 75 (30.2) 6 (9.4) <0.001 <0.001
Obese (BMI ≥25) 52 (8.7) 328 (43.9) 129 (29.7) 143 (57.7) 56 (87.5)
Body weight (kg) 59 (10) 70 (11) 66 (10) 73 (10) 82 (13) <0.001 <0.001
Height (cm) 165 (8) 167 (8) 166 (8) 168 (7) 170 (9) <0.001 <0.001
SBP (mmHg) 115 (15) 123 (17) 120 (16) 126 (16) 132 (20) <0.001 <0.001
WC (cm) 73 (7) 82 (8) 79 (7) 85 (6) 93 (9) <0.001 <0.001
Platelet count (×104/mL) 240 (47) 244 (51) 243 (52) 244 (50) 250 (51) 0.17 0.38
Fasting glucose (mg/dL) 91 (9) 101 (17) 98 (14) 103 (17) 112 (26) <0.001 <0.001
Triglyceride (mg/dL) 85 (39) 144 (97) 118 (66) 174 (120) 203 (119) <0.001 <0.001
AST (IU/L) 24 (9) 27 (13) 25 (11) 30 (13) 38 (18) <0.001 <0.001
ALT (IU/L) 19 (9) 29 (23) 22 (15) 35 (27) 54 (28) <0.001 <0.001
Total cholesterol (mg/dL) 190 (33) 199 (37) 196 (35) 203 (38) 206 (38) <0.001 <0.001
HDL cholesterol (mg/dL) 60 (12) 52 (10) 54 (10) 49 (9) 47 (8) <0.001 <0.001
LDL cholesterol (mg/dL) 111 (24) 122 (27) 118 (26) 126 (29) 128 (29) <0.001 <0.001
SUA (mg/dL) 5.03 (1.29) 5.75 (1.38) 5.46 (1.32) 6.09 (1.32) 6.43 (1.51) <0.001 <0.001
NFS –2.44 (1.12) –2.00 (1.15) –2.01 (1.14) –2.01 (1.17) –1.86 (1.17) <0.001 <0.001
Prevalence of hyperuricemia and metabolic disease n (%)
Hyperuricemia (19.1) 76 (12.8) 181 (24.2) 71 (16.3) 80 (32.3) 30 (46.9) <0.001 <0.001
HTN (22.9) 72 (12.1) 235 (31.5) 113 (26.0) 90 (36.3) 32 (50.0) <0.001 <0.001
Low LDL or statin medication(24.3) 93 (15.6) 234 (31.3) 114 (26.2) 99 (39.9) 21 (32.8) <0.001 <0.001
DM (6.4) 15 (2.5) 71 (9.5) 25 (5.7) 33 (13.3) 13 (20.3) <0.001 <0.001

Multivariate risk factor analysis for patients with elevated NFS grade by logistic regression

Variable NFS grade Odds ratio Confidence interval P
0 (n = 1,051) ≥1 (n = 292)
Age (year) 44.7 (12) 54.3 (8.9) 1.08 1.06–1.09 <0.001
Male sex 572 (54.4) 202 (69.2) 1.59 1.15–2.20 0.005
BMI (kg/m2) 22.9 (3.1) 25.2 (3.2) 1.27 1.20–1.34 <0.001
HTN 205 (19.5) 102 (34.9) 0.73 0.51–1.04 0.085
Diabetes mellitus 36 (3.4) 50 (17.1) 2.82 1.70–4.69 <0.001
NAFLD 538 (51.2) 209 (71.6) 0.97 0.68–1.39 0.88
Abnormal ALT 115 (10.9) 50 (17.1) 0.68 0.43–1.05 0.082
Hyperuricemia 198 (18.8) 59 (20.2) 0.94 0.65–1.37 0.75
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