Association Between Sex-specific Serum Uric Acid and Non-alcoholic Fatty Liver Disease in Chinese Adults: a Large Population-based Study

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2015 May 2

PMID 25929934

Citations 39

Authors

Sheng-Jie Wu

Gui-Qi Zhu

Bo-Zhi Ye

Fan-Qi Kong

Zai-Xing Zheng

Hai Zou

Ke-Qing Shi

Lu Lin

Martin Braddock

Wei-Jian Huang

Yong-Ping Chen

Ming-Hua Zheng

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to examine the association between sex-specific serum uric acid (sUA) levels and NAFLD in a large population-based study.A total of 60,455 subjects from 2 separate medical centers were included. Sex-specific sUA quartiles (Q1-Q4) were defined: ≤330, 331-380, 381-435, and ≥436 μmol/L for male; ≤230, 231-270, 271-310, and ≥311 μmol/L for female. The odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) for NAFLD were calculated across each quartile of sUA, using the Q1 as reference.After adjusting for known confounding variables in this study, the ORs for NAFLD in the cross-sectional population were 1.211 (95% CI 1.109-1.322), 1.519 (95% CI 1.395-1.654), 1.903 (95% CI 1.748-2.072) for Q2, Q3, and Q4, respectively. In the longitudinal population, compared with the reference group, those in Q2, Q3, and Q4 had HRs of 1.127 (95% CI 0.956-1.330), 1.380 (95% CI 1.157-1.644), 1.589 (95% CI 1.310-1.927) for NAFLD, respectively. Analysis for the sex-specific subgroup showed the adjusted ORs for Q4 versus Q1 were 2.898 (95% CI 2.36-3.588) in female and 1.887 (95% CI 1.718-2.072) in male in the cross-sectional population. In the longitudinal population, the HRs for the Q4 were 2.355 (95% CI 1.702-3.259) in female and 1.249 (95% CI 0.975-1.601) in male, compared with Q1.We report that a sex-specific sUA level is independently associated with NAFLD. The association between sUA and NAFLD was significantly greater in females than in males.

Citing Articles

Serum uric acid and nonalcoholic fatty liver disease.

Fan J, Wang D Front Endocrinol (Lausanne). 2024; 15():1455132.

PMID: 39669496 PMC: 11635646. DOI: 10.3389/fendo.2024.1455132.

Association between Body Mass Index and Serum Uric Acid: mediation analysis involving liver enzymes indicators.

Deng F, Wang Q, Wen X, Xu X, Jia L, He H BMC Public Health. 2024; 24(1):3007.

PMID: 39478457 PMC: 11526625. DOI: 10.1186/s12889-024-20457-1.

Development and validation of a nomogram model for predicting the risk of MAFLD in the young population.

Yuan Y, Xu M, Zhang X, Tang X, Zhang Y, Yang X Sci Rep. 2024; 14(1):9376.

PMID: 38654043 PMC: 11039663. DOI: 10.1038/s41598-024-60100-y.

Association of serum uric acid Levels with metabolic syndromes in Korean adolescents.

Seo Y, Shim Y, Lee H, Hwang J Front Endocrinol (Lausanne). 2024; 14:1159248.

PMID: 38169712 PMC: 10758490. DOI: 10.3389/fendo.2023.1159248.

Metabolic characteristics of non-obese and obese metabolic dysfunction-associated fatty liver disease in type 2 diabetes mellitus and its association with diabetic peripheral neuropathy and diabetic retinopathy.

Dang S, Gao L, Li Y, Zhang R, Xu J Front Med (Lausanne). 2023; 10:1216412.

PMID: 37828942 PMC: 10566373. DOI: 10.3389/fmed.2023.1216412.

References

Ekstedt M, Hagstrom H, Nasr P, Fredrikson M, Stal P, Kechagias S . Fibrosis stage is the strongest predictor for disease-specific mortality in NAFLD after up to 33 years of follow-up. Hepatology. 2014; 61(5):1547-54. DOI: 10.1002/hep.27368. View

Fan J, Saibara T, Chitturi S, Kim B, Sung J, Chutaputti A . What are the risk factors and settings for non-alcoholic fatty liver disease in Asia-Pacific?. J Gastroenterol Hepatol. 2007; 22(6):794-800. DOI: 10.1111/j.1440-1746.2007.04952.x. View

Waring W, Webb D, Maxwell S . Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers. J Cardiovasc Pharmacol. 2001; 38(3):365-71. DOI: 10.1097/00005344-200109000-00005. View

Fung J, Lee C, Chan M, Seto W, Lai C, Yuen M . High prevalence of non-alcoholic fatty liver disease in the Chinese - results from the Hong Kong liver health census. Liver Int. 2014; 35(2):542-9. DOI: 10.1111/liv.12619. View

Kanellis J, Watanabe S, Li J, Kang D, Li P, Nakagawa T . Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension. 2003; 41(6):1287-93. DOI: 10.1161/01.HYP.0000072820.07472.3B. View

Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M . Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes. 2001; 50(8):1844-50. DOI: 10.2337/diabetes.50.8.1844. View

Zoppini G, Fedeli U, Gennaro N, Saugo M, Targher G, Bonora E . Mortality from chronic liver diseases in diabetes. Am J Gastroenterol. 2014; 109(7):1020-5. DOI: 10.1038/ajg.2014.132. View

Borges R, Ribeiro A, Zanella M, Batista M . Uric acid as a factor in the metabolic syndrome. Curr Hypertens Rep. 2010; 12(2):113-9. DOI: 10.1007/s11906-010-0098-2. View

Marangella M . Uric acid elimination in the urine. Pathophysiological implications. Contrib Nephrol. 2004; 147:132-148. DOI: 10.1159/000082551. View

10.

Kawamoto R, Tabara Y, Kohara K, Kusunoki T, Abe M, Miki T . Serum uric acid is more strongly associated with impaired fasting glucose in women than in men from a community-dwelling population. PLoS One. 2013; 8(6):e65886. PMC: 3681777. DOI: 10.1371/journal.pone.0065886. View

11.

Sirota J, McFann K, Targher G, Johnson R, Chonchol M, Jalal D . Elevated serum uric acid levels are associated with non-alcoholic fatty liver disease independently of metabolic syndrome features in the United States: Liver ultrasound data from the National Health and Nutrition Examination Survey. Metabolism. 2012; 62(3):392-9. PMC: 3565047. DOI: 10.1016/j.metabol.2012.08.013. View

12.

Baba T, Amasaki Y, Soda M, Hida A, Imaizumi M, Ichimaru S . Fatty liver and uric acid levels predict incident coronary heart disease but not stroke among atomic bomb survivors in Nagasaki. Hypertens Res. 2007; 30(9):823-9. DOI: 10.1291/hypres.30.823. View

13.

Ruggiero C, Cherubini A, Ble A, Bos A, Maggio M, Dixit V . Uric acid and inflammatory markers. Eur Heart J. 2006; 27(10):1174-81. PMC: 2668163. DOI: 10.1093/eurheartj/ehi879. View

14.

Socha P, Wierzbicka A, Neuhoff-Murawska J, Wlodarek D, Podlesny J, Socha J . Nonalcoholic fatty liver disease as a feature of the metabolic syndrome. Rocz Panstw Zakl Hig. 2007; 58(1):129-37. View

15.

Xu C, Yu C, Xu L, Miao M, Li Y . High serum uric acid increases the risk for nonalcoholic Fatty liver disease: a prospective observational study. PLoS One. 2010; 5(7):e11578. PMC: 2904389. DOI: 10.1371/journal.pone.0011578. View

16.

St George D . Nurse triage in accident and emergency departments. BMJ. 1992; 304(6838):1379. PMC: 1882010. DOI: 10.1136/bmj.304.6838.1379. View

17.

Day C, Saksena S . Non-alcoholic steatohepatitis: definitions and pathogenesis. J Gastroenterol Hepatol. 2002; 17 Suppl 3:S377-84. DOI: 10.1046/j.1440-1746.17.s3.31.x. View

18.

Farrell G, Chitturi S, Lau G, Sollano J . Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary. J Gastroenterol Hepatol. 2007; 22(6):775-7. DOI: 10.1111/j.1440-1746.2007.05002.x. View

19.

Jian-gao F . Guidelines for management of nonalcoholic fatty liver disease: an updated and revised edition. Zhonghua Gan Zang Bing Za Zhi. 2010; 18(3):163-6. View

20.

Kim S, Guevara J, Kim K, Choi H, Heitjan D, Albert D . Hyperuricemia and coronary heart disease: a systematic review and meta-analysis. Arthritis Care Res (Hoboken). 2010; 62(2):170-80. PMC: 3156692. DOI: 10.1002/acr.20065. View