Department of Occupational Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul 110-746, South Korea.
Metabolism. 2011 Jun;60(6):860-6. doi: 10.1016/j.metabol.2010.08.005. Epub 2010 Sep 21.
The objective of the study was to assess the prospective association between serum uric acid levels and incident nonalcoholic fatty liver disease in a cohort of healthy Korean men. A cohort study was performed on 5741 Korean men, 30 to 59 years of age, with no evidence of fatty liver disease on liver ultrasound and with no major risk factors for liver disease at baseline. Study participants were followed in annual or biennial health examinations between 2002 and 2008. The presence of fatty liver was determined at each examination by ultrasound. Cox proportional hazards models were used to evaluate the association of baseline and time-dependent levels of serum uric acid with incident fatty liver, adjusted for potential confounders. During 23,995 person-years of follow-up, 1717 participants developed fatty liver on ultrasound examination. After adjustment for age, body mass index, smoking, and alcohol intake, the hazard ratios (95% confidence intervals) for incident fatty liver comparing quartiles 2 to 4 of serum uric acid to quartile 1 were 1.17 (1.01-1.37), 1.28 (1.11-1.48), and 1.51 (1.31-1.73), respectively (P for trend = .001). The adjusted hazard ratio comparing participants with hyperuricemia (serum uric acid ≥7.0 mg/dL) to those with normouricemia (<7.0 mg/dL) was 1.29 (1.14-1.46). A graded and statistically significant association persisted after adjusting for other cardiometabolic factors and also in time-dependent models. Serum uric acid was an independent risk factor of incident fatty liver detected by ultrasonography. Additional research should clarify the mechanisms underlying this association and the role of hyperuricemia in the development of fatty liver.
本研究旨在评估血清尿酸水平与健康韩国男性非酒精性脂肪性肝病（NAFLD）发病风险之间的前瞻性关联。本队列研究纳入了 5741 名年龄在 30 至 59 岁之间的韩国男性，基线时超声检查未见脂肪肝，且无肝脏疾病的主要危险因素。研究对象在 2002 年至 2008 年间接受了每年或每两年一次的健康检查。每次检查均通过超声检查来确定脂肪肝的存在。使用 Cox 比例风险模型评估基线和时变血清尿酸水平与新发脂肪肝之间的关联，调整了潜在混杂因素。在 23995 人年的随访期间，1717 名参与者经超声检查诊断为脂肪肝。在校正年龄、体重指数、吸烟和饮酒后，血清尿酸四分位 2 至 4 与四分位 1 相比，发生脂肪肝的风险比（95%置信区间）分别为 1.17（1.01-1.37）、1.28（1.11-1.48）和 1.51（1.31-1.73）（趋势 P 值<.001）。与正常尿酸血症（血清尿酸<7.0 mg/dL）相比，血尿酸升高（血清尿酸≥7.0 mg/dL）患者的调整后风险比为 1.29（1.14-1.46）。在校正其他心血管代谢因素和时变模型后，这种调整后的关联仍然存在且呈梯度和统计学显著。血清尿酸是超声检查检测到的新发脂肪肝的独立危险因素。进一步的研究应阐明这种关联的潜在机制以及高尿酸血症在脂肪肝发展中的作用。
