4.7 Article

The Additive Values of the Classification of Higher Serum Uric Acid Levels as a Diagnostic Criteria for Metabolic-Associated Fatty Liver Disease

Journal

NUTRIENTS
Volume 14, Issue 17, Pages -

Publisher

MDPI
DOI: 10.3390/nu14173587

Keywords

uric acid; liver fat content; metabolic associated fatty liver disease; non-alcoholic fatty liver disease; steatosis

Funding

  1. National Natural Science Foundation of China [81870404, 81670518, 82100648]
  2. Guangdong Basic and Applied Basic Research Foundation [2022A151501225369]
  3. China Postdoctoral Science Foundation [2020M683128]

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Serum uric acid plays an important role in the diagnosis of metabolic-associated fatty liver disease, with high uric acid levels associated with an increased risk of severe steatosis. In lean/normal-weight NAFLD patients, higher uric acid levels still contribute to a higher risk of severe steatosis.
Serum uric acid (SUA) is regarded as an independent risk factor for nonalcoholic fatty liver disease (NAFLD). However, the role of SUA in the new diagnosis flowchart of metabolic-associated fatty liver disease (MAFLD) remains unclear. A cross-sectional study enrolled consecutive individuals with ultrasonography and magnetic resonance imaging-based proton density fat fraction (MRI-PDFF) measurements in the First Affiliated Hospital of Sun Yat-sen University from January 2015 to December 2021. All patients were divided into four groups according to their baseline SUA levels and sex. Of the 3537 ultrasound-diagnosed and 1017 MRI-PDFF-diagnosed MAFLD patients included, the prevalence of severe steatosis determined with ultrasound or MRI-PDFF increased across the serum SUA quartiles. The SUA cutoffs were identified as >= 478 mu mol/L and >= 423.5 mu mol/L for severe steatosis in male and female MAFLD, respectively. Furthermore, using these cutoff values, patients with higher SUA levels in the NAFLD-non-MAFLD group had higher liver fat contents than those without (16.0% vs. 9.7%, p < 0.001). The lean/normal-weight NAFLD-non-MAFLD patients with higher SUA levels are still at high risk of severe steatosis. This study supports the rationale for SUA being established as another risk factor for metabolic dysfunctions in lean/normal-weight MAFLD.

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