Wijarnpreecha Karn, Panjawatanan Panadeekarn, Lekuthai Natasorn, Thongprayoon Charat, Cheungpasitporn Wisit, Ungprasert Patompong
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA.
Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Liver Int. 2017 Jun;37(6):906-918. doi: 10.1111/liv.13329. Epub 2016 Dec 31.
The association between hyperuricaemia and nonalcoholic fatty liver disease (NAFLD), one of the leading causes of cirrhosis worldwide, has been demonstrated in recent epidemiological studies. This meta-analysis was conducted to summarize all available data and to estimate the risk of NAFLD among subjects with hyperuricaemia.
Comprehensive literature review was conducted using MEDLINE and EMBASE database through August 2016 to identify studies that compared the risk of NAFLD among subjects with hyperuricaemia vs those with normal uric acid level. Effect estimates from individual study were extracted and combined together using random-effect, generic inverse variance method of DerSimonian and Laird.
Twenty-five studies met the eligibility criteria and were included in the meta-analysis. The risk of NAFLD in subjects with hyperuricaemia was significantly higher than subjects with normal uric acid level with the pooled odds ratio (OR) of 1.97 (95% confidence interval (CI), 1.69-2.29). The heterogeneity between studies of the overall analysis was high with an I of 87%. Subgroup analysis based on 11 studies that provided data on males subgroup and nine studies that provided data on females subgroup showed that the risk was significantly increased for both sexes with pooled OR of 1.64 (95% CI, 1.40-1.93) among males and pooled OR of 2.21 (95% CI, 1.85-2.64) among females.
A significantly increased risk of NAFLD among patients with hyperuricaemia was demonstrated in this meta-analysis. Further studies are required to establish the role of uric acid in the pathogenesis of NAFLD.
高尿酸血症与非酒精性脂肪性肝病（NAFLD）之间的关联已在近期的流行病学研究中得到证实，NAFLD是全球肝硬化的主要病因之一。本荟萃分析旨在总结所有可用数据，并评估高尿酸血症患者患NAFLD的风险。
通过检索MEDLINE和EMBASE数据库，对截至2016年8月的文献进行全面综述，以确定比较高尿酸血症患者与尿酸水平正常者患NAFLD风险的研究。提取个体研究的效应估计值，并使用DerSimonian和Laird的随机效应、通用逆方差法进行合并。
25项研究符合纳入标准并被纳入荟萃分析。高尿酸血症患者患NAFLD的风险显著高于尿酸水平正常者，合并优势比（OR）为1.97（95%置信区间（CI），1.69 - 2.29）。总体分析中各研究之间的异质性较高，I²为87%。基于11项提供男性亚组数据的研究和9项提供女性亚组数据的研究进行的亚组分析显示，两性的风险均显著增加，男性的合并OR为1.64（95%CI，1.40 - 1.93），女性的合并OR为2.21（95%CI，1.85 - 2.64）。
本荟萃分析表明，高尿酸血症患者患NAFLD的风险显著增加。需要进一步研究以确定尿酸在NAFLD发病机制中的作用。
