Golmohammadi Sima, Tavasoli Marjan, Asadi Nadia
Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Clin Exp Gastroenterol. 2020 Aug 20;13:299-304. doi: 10.2147/CEG.S253619. eCollection 2020.
BACKGROUND/AIMS: The number of patients with nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) is on the rise. Epidemiological studies have shown the role of hyperuricemia in the development of NAFLD and CKD through oxidative stress and inflammatory mediators. Therefore, this study was conducted to investigate the prevalence and risk factors of hyperuricemia in patients with CKD and NAFLD in Iran.
This study was conducted in 450 CKD patients. NAFLD was diagnosed by ultrasonography. According to the serum uric acid level, all CKD NAFLD patients were divided into non-hyperuricemia and hyperuricemia groups. The patients' demographic and clinical data such as age, sex, abdominal obesity, metabolic syndrome, diabetes, hypertension, CRP, hepatic steatosis, blood pressure, serum uric acid (UA), lipid and creatinine were collected for analysis.
A total of 279 cases (62%) were diagnosed with NAFLD. The prevalence rate of NFALD in CKD patients was significantly lower in normal UA level than hyperuricemia (42.7% vs 57.3%) (P=0.039). The prevalence of hyperuricemia was about 57.3% in patients with CKD and NAFLD. Accordingly, 279 CKD patients with NAFLD were enrolled and divided into hyperuricemia (n =160) and non-hyperuricemia groups (n =119). Patients with hyperuricemia showed higher creatinine and lipid levels, and a lower GFR compared to patients with normal uric acid levels (P< 0.05). However, no significant difference was observed in age, sex, abdominal obesity, metabolic syndrome, hypertension, type 2 diabetes, CRP, and steatosis between hyperuricemia and non-hyperuricemia groups (P>0.05). Three factors, including type 2 diabetes, hyperlipidemia, and a low GFR, serve as independent risk factors for hyperuricemia (P<0.05).
The results showed a high prevalence of hyperuricemia in patients with CKD and NAFLD. A more comprehensive strategic management is necessary to address the potential harmful effects of hyperuricemia on the health of CKD NAFLD cases.
背景/目的：非酒精性脂肪性肝病（NAFLD）和慢性肾脏病（CKD）患者数量正在增加。流行病学研究表明高尿酸血症通过氧化应激和炎症介质在NAFLD和CKD的发展中起作用。因此，本研究旨在调查伊朗CKD和NAFLD患者高尿酸血症的患病率及危险因素。
本研究纳入450例CKD患者。通过超声诊断NAFLD。根据血清尿酸水平，将所有CKD合并NAFLD患者分为非高尿酸血症组和高尿酸血症组。收集患者的人口统计学和临床数据，如年龄、性别、腹型肥胖、代谢综合征、糖尿病、高血压、CRP、肝脂肪变性、血压、血清尿酸（UA）、血脂和肌酐进行分析。
共279例（62%）患者被诊断为NAFLD。CKD患者中，正常尿酸水平组的NAFLD患病率显著低于高尿酸血症组（42.7%对57.3%）（P=0.039）。CKD合并NAFLD患者的高尿酸血症患病率约为57.3%。据此，将279例CKD合并NAFLD患者纳入研究并分为高尿酸血症组（n =160）和非高尿酸血症组（n =119）。与尿酸水平正常的患者相比，高尿酸血症患者的肌酐和血脂水平更高，肾小球滤过率（GFR）更低（P<0.05）。然而，高尿酸血症组和非高尿酸血症组在年龄、性别、腹型肥胖、代谢综合征、高血压、2型糖尿病、CRP和脂肪变性方面未观察到显著差异（P>0.05）。2型糖尿病、高脂血症和低GFR这三个因素是高尿酸血症的独立危险因素（P<0.05）。
结果显示CKD合并NAFLD患者高尿酸血症患病率较高。有必要采取更全面的策略性管理措施，以应对高尿酸血症对CKD合并NAFLD患者健康的潜在有害影响。
