Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, 1 Friendship Road, Yuzhong District, Chongqing, NO, China.
The Public Health Center, the First Affiliated Hospital of Chongqing Medical University, 1 Friendship Road, Yuzhong District, Chongqing, NO, China.
Lipids Health Dis. 2017 Oct 16;16(1):202. doi: 10.1186/s12944-017-0531-5.
Previous studies found elevated serum uric acid (SUA) was associated with the development or progression of non-alcoholic fatty liver disease (NAFLD) in general population; in this study we aim to investigate the association of SUA and the severity of NAFLD based on grade of fatty liver on ultrasonography in non-obese subjects.
Data were obtained from subjects via routine physical examinations in the Public Health Center of our hospital between 2011 and 2014. The data included completed anthropometry and blood biochemical indicators and the results of abdominal ultrasound. The diagnosis of NAFLD was according to the clinical diagnosis of the Guidelines for the diagnosis and treatment of nonalcoholic fatty liver disease in 2008.
In total, 95,924 subjects were analyzed in this study. The prevalence rate of lean-NAFLD was 8.16%, among which 7.58% had mild steatosis, and 0.58% had moderate and severe steatosis. The prevalence of fatty liver was increased progressively with SUA. Among which the prevalence of mild fatty liver from Q1 to Q4 were 10.33%, 18.39%, 23.11% and 25.93%; the prevalence of moderate and severe fatty liver from Q1 to Q4 were 1.06%, 2.82%, 5.05% and 7.27%. Lean-subjects with hyperuricemia had an OR of 1.718 (95% CI 1.622-1.820) to have NAFLD, after adjusted for other metabolic disorders. The area under curve (AUC) for detecting mild fatty liver based on SUA was 0.70; and the AUC for detecting moderate and severe fatty liver based on SUA was 0.78.
Our data showed positive associations between elevated SUA levels and lean-NAFLD risk in the inland Chinese adults, independent of other metabolic factors. Our study also suggests that SUA could be considered as a simple and non-invasive method to follow up patients with lean-NAFLD.
先前的研究发现，血清尿酸（SUA）升高与一般人群中非酒精性脂肪性肝病（NAFLD）的发生或进展有关；在这项研究中，我们旨在根据非肥胖人群超声检查中脂肪肝的程度，研究 SUA 与 NAFLD 严重程度之间的关系。
数据来自于 2011 年至 2014 年期间我院公共卫生中心的常规体检对象。数据包括完成的人体测量和血液生化指标以及腹部超声检查结果。NAFLD 的诊断依据 2008 年《非酒精性脂肪性肝病诊疗指南》的临床诊断。
本研究共分析了 95924 例患者。瘦型 NAFLD 的患病率为 8.16%，其中 7.58%为轻度脂肪变性，0.58%为中重度脂肪变性。随着 SUA 的升高，脂肪肝的患病率逐渐增加。其中，Q1 到 Q4 的轻度脂肪肝患病率分别为 10.33%、18.39%、23.11%和 25.93%；Q1 到 Q4 的中重度脂肪肝患病率分别为 1.06%、2.82%、5.05%和 7.27%。高尿酸血症的瘦型患者发生 NAFLD 的 OR 值为 1.718（95%CI 1.622-1.820），校正其他代谢紊乱因素后 OR 值为 1.718。基于 SUA 检测轻度脂肪肝的曲线下面积（AUC）为 0.70；基于 SUA 检测中重度脂肪肝的 AUC 为 0.78。
我们的数据显示，在中国内陆成年人中，SUA 水平升高与瘦型 NAFLD 风险呈正相关，与其他代谢因素无关。我们的研究还表明，SUA 可以作为一种简单、非侵入性的方法来监测瘦型 NAFLD 患者。
