Yang Sisi, Ye Ziliang, Liu Mengyi, Zhang Yanjun, Wu Qimeng, Zhou Chun, Zhang Zhuxian, He Panpan, Zhang Yuanyuan, Li Huan, Liu Chengzhang, Qin Xianhui
Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou, China.
Institute of Biomedicine, Anhui Medical University, Hefei, China.
Clin Endocrinol (Oxf). 2023 Jan;98(1):49-58. doi: 10.1111/cen.14810. Epub 2022 Aug 22.
The association between serum uric acid (SUA) and mortality from cardiovascular diseases (CVDs) in nonalcoholic fatty liver disease (NAFLD) participants remains uncertain. We aim to investigate the relations of SUA with the risk of CVD mortality among adults with and without NAFLD.
Using data from National Health and Nutrition Examination Survey (NHANES) 1999-2014, a total of 17,858 participants were recruited. Of these, 5767 had a US Fatty Liver Index (USFLI) ≥30 and were classified as having NAFLD. Death information was obtained from the National Death Index until 2015.
During a mean follow-up of 8.3 years, 427 participants died from CVD. Overall, there was a positive association between SUA and CVD mortality among participants with NAFLD (per SD μmol/L increment, adjusted hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.16-1.68). Accordingly, among those with NAFLD, when SUA was assessed as quartiles, compared with those in the first quartile, a significantly higher risk of CVD mortality was found in participants in the fourth quartile (adjusted HR, 2.69; 95% CI, 1.51-4.80). However, there was no significant association between SUA and CVD mortality among participants without NAFLD (per SD μmol/L increment, adjusted HR, 1.01; 95% CI, 0.83-1.22). Similar trends were found for all-cause mortality. Similar results were also found when using FLI ≥ 60 to define NAFLD.
In a large and nationally representative sample of US adults, a higher SUA was significantly associated with a higher risk of CVD mortality among participants with NAFLD, but not in those without NAFLD.
非酒精性脂肪性肝病（NAFLD）参与者的血清尿酸（SUA）与心血管疾病（CVD）死亡率之间的关联仍不确定。我们旨在研究SUA与有无NAFLD的成年人CVD死亡风险之间的关系。
利用1999 - 2014年美国国家健康与营养检查调查（NHANES）的数据，共招募了17858名参与者。其中，5767人的美国脂肪肝指数（USFLI）≥30，被归类为患有NAFLD。直到2015年，死亡信息均来自国家死亡指数。
在平均8.3年的随访期间，427名参与者死于CVD。总体而言，NAFLD参与者中SUA与CVD死亡率呈正相关（每增加1个标准差μmol/L，调整后风险比[HR]为1.40；95%置信区间[CI]为1.16 - 1.68）。因此，在患有NAFLD的人群中，当将SUA评估为四分位数时，与第一四分位数的参与者相比，第四四分位数的参与者CVD死亡风险显著更高（调整后HR为2.69；95% CI为1.51 - 4.80）。然而，在没有NAFLD的参与者中，SUA与CVD死亡率之间没有显著关联（每增加1个标准差μmol/L，调整后HR为1.01；95% CI为0.83 - 1.22）。全因死亡率也呈现类似趋势。当使用FLI≥60来定义NAFLD时，也得到了类似的结果。
在美国成年人的一个具有全国代表性的大样本中，较高的SUA与NAFLD参与者中较高的CVD死亡风险显著相关，但在没有NAFLD的参与者中并非如此。
