Yang Chao, Yang Shujuan, Feng Chunhong, Zhang Chuan, Xu Weiwei, Zhang Liyun, Yan Yixin, Deng Jiaqi, Ohore Okugbe Ebiotubo, Li Jing
Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Luzhou, China.
Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu, China.
PLoS One. 2018 Feb 7;13(2):e0192396. doi: 10.1371/journal.pone.0192396. eCollection 2018.
Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease that is associated with high serum uric acid (SUA) levels, although the effects of high SUA levels on NAFLD remission remain unclear. In addition, it is unclear whether obesity and high SUA levels have a combined effect on NAFLD remission. This retrospective cohort study evaluated male employees of seven Chinese companies and investigated the association between high SUA levels and NAFLD remission, as well as the potential combined effect of high SUA levels and obesity on NAFLD remission. The study followed 826 men with NAFLD for 4 years, and the NAFLD remission rate was 23.2% (192/826). Comparing to obese and non-obese individuals with normouricemia, individuals with hyperuricemia had significant higher values for total cholesterol, triglycerides, creatinine, and aspartate transaminase (all P < 0.05). Among non-obese individuals, hyperuricemia was associated with a lower NAFLD remission rate, compared to normouricemia (P < 0.001). However, no significant difference was observed between hyperuricemia and normouricemia among obese subjects (P > 0.05). Similar results were observed in the multivariate cox proportional hazard regression analyses. Compared to the normouricemia subjects, individuals with hyperuricemia had a significant lower likelihood of NAFLD remission (RR = 0.535, 95% CI: 0.312-0.916); and obese subjects had a significant lower likelihood of NAFLD remission than the non-obese individuals (RR = 0.635, 95% CI: 0.439-0.918). In addition, the interaction between hyperuricemia and obesity had a statistically significant effect on NAFLD remission (P = 0.048). In conclusion, hyperuricemia and obesity may be involved in NAFLD development and remission, with similar pathogenic mechanisms. Further studies are needed to confirm our findings and determine how to improve these individuals' conditions.
非酒精性脂肪性肝病（NAFLD）是一种常见的慢性病，与高血清尿酸（SUA）水平相关，尽管高SUA水平对NAFLD缓解的影响尚不清楚。此外，肥胖和高SUA水平对NAFLD缓解是否具有联合作用也不清楚。这项回顾性队列研究评估了中国七家公司的男性员工，调查了高SUA水平与NAFLD缓解之间的关联，以及高SUA水平和肥胖对NAFLD缓解的潜在联合作用。该研究对826名患有NAFLD的男性进行了4年的随访，NAFLD缓解率为23.2%（192/826）。与尿酸正常的肥胖和非肥胖个体相比，高尿酸血症个体的总胆固醇、甘油三酯、肌酐和天冬氨酸转氨酶值显著更高（均P<0.05）。在非肥胖个体中，与尿酸正常者相比，高尿酸血症与较低的NAFLD缓解率相关（P<0.001）。然而，肥胖受试者中高尿酸血症和尿酸正常者之间未观察到显著差异（P>0.05）。多变量cox比例风险回归分析中观察到类似结果。与尿酸正常者相比，高尿酸血症个体NAFLD缓解的可能性显著更低（RR=0.535，95%CI：0.312-0.916）；肥胖受试者NAFLD缓解的可能性比非肥胖个体显著更低（RR=0.635，95%CI：0.439-0.918）。此外，高尿酸血症与肥胖之间的相互作用对NAFLD缓解有统计学显著影响（P=0.048）。总之，高尿酸血症和肥胖可能通过相似的致病机制参与NAFLD的发生和缓解。需要进一步研究来证实我们的发现并确定如何改善这些个体的状况。
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