Serum uric acid to creatinine ratio is associated with higher prevalence of NAFLD detected by FibroScan in the United States.

BACKGROUND

The association between the serum uric acid (sUA) to creatinine ratio (sUA/Cr) and non-alcoholic fatty liver disease (NAFLD) has not been sufficiently clarified. In this study, we investigated the relationship between sUA/Cr and NAFLD among participants in the United States.

METHODS

We performed a cross-sectional study based on data from the National Health and Nutrition examination Survey (NHANES) 2017-2018. A measured controlled attenuation parameter (CAP) value of ≥274 dB/m detected by Fibroscan was used to identify hepatic steatosis. SUA/Cr was calculated as sUA divided by serum creatinine. Multivariate logistic regression analysis was used to estimate the association between sUA/Cr and NAFLD. The adjusted odds ratio (OR) of sUA/Cr for NAFLD was estimated, and subgroup analysis stratified by sex was also conducted. The nonlinear relationship between sUA/Cr and NAFLD was further described using smooth curve fittings and threshold-effect analysis.

RESULTS

We found that sUA/Cr was positively correlated with NAFLD status after fully adjustment for confounding factors. In subgroup analysis stratified by sex, the positive interaction between sUA/Cr and NAFLD status only existed in women but not in men. Moreover, the nonlinear association between sUA/Cr and NAFLD status was an inverted U-shaped curve with an inflection point at 9.7 among men.

CONCLUSIONS

Our study identified that sUA/Cr was positively associated with the risk of NAFLD among individuals in the United States. Moreover, the correlation between sUA/Cr and NAFLD differed according to sex.