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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. 2013 Mar; 62(3):392-9.M

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 >6.9mg/dL for men and ≤3.7, 3.8-4.5, 4.6-5.3, and >5.3mg/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.

Authors+Show Affiliations

Division of Renal Diseases & Hypertension, University of Colorado Denver, Aurora, CO, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23036645

Citation

Sirota, Jeffrey C., et al. "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: Clinical and Experimental, vol. 62, no. 3, 2013, pp. 392-9.
Sirota JC, McFann K, Targher G, et al. 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. 2013;62(3):392-9.
Sirota, J. C., McFann, K., Targher, G., Johnson, R. J., Chonchol, M., & Jalal, D. I. (2013). 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: Clinical and Experimental, 62(3), 392-9. https://doi.org/10.1016/j.metabol.2012.08.013
Sirota JC, et al. 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. 2013;62(3):392-9. PubMed PMID: 23036645.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Sirota,Jeffrey C, AU - McFann,Kim, AU - Targher,Giovanni, AU - Johnson,Richard J, AU - Chonchol,Michel, AU - Jalal,Diana I, Y1 - 2012/10/02/ PY - 2012/03/19/received PY - 2012/08/23/revised PY - 2012/08/24/accepted PY - 2012/10/6/entrez PY - 2012/10/6/pubmed PY - 2013/7/3/medline SP - 392 EP - 9 JF - Metabolism: clinical and experimental JO - Metabolism VL - 62 IS - 3 N2 - 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 >6.9mg/dL for men and ≤3.7, 3.8-4.5, 4.6-5.3, and >5.3mg/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. SN - 1532-8600 UR - https://www.unboundmedicine.com/medline/citation/23036645/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_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0026-0495(12)00317-4 DB - PRIME DP - Unbound Medicine ER -