China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
School of Qi Huang, Beijing University of Chinese Medicine, Beijing, China.
Am J Physiol Endocrinol Metab. 2023 Jul 1;325(1):E62-E71. doi: 10.1152/ajpendo.00001.2023. Epub 2023 Jun 7.
According to the latest consensus statement, fatty liver complicated by specific metabolic abnormalities can be diagnosed as metabolic dysfunction-associated fatty liver disease (MAFLD) in nonobese patients without type 2 diabetes mellitus (TDM). However, hyperuricemia (HUA), a manifestation of metabolic disorders, is excluded from diagnostic criteria. This study explored the association between HUA and MAFLD in nonobese patients without TDM. A total of 28,187 participants were recruited from the Examination Center of the China-Japan Friendship Hospital from 2018 to 2022 and divided into four subgroups: nonobese patients without TDM, obese patients without TDM, nonobese patients with TDM, and obese patients with TDM. MAFLD was diagnosed by ultrasound combined with laboratory examinations. The association of HUA with MAFLD subgroups was performed by logistical regression analysis. The predictive ability of UA for MAFLD subgroups was assessed by receiver operating characteristics (ROC). HUA was positively associated with MAFLD in nonobese patients without TDM in both males and females, even after adjusting for sex, BMI, dyslipidemia, and abnormal liver function. The association increased gradually with aging, especially in those over 40 yr old. HUA was an independent risk factor for MAFLD in nonobese patients without TDM. We suggest that UA abnormalities might be considered in the diagnosis of MAFLD in nonobese patients without TDM. HUA is an independent risk factor for MAFLD in nonobese patients without TDM. The association of HUA with MAFLD in nonobese patients without TDM increased gradually with aging, especially in those over 40 yr old. In nonobese patients without TDM, univariate analysis showed that females with HUA had a higher risk of MAFLD than males. However, the difference was narrowed after adjustment for confounders.
根据最新的共识声明，非肥胖且无 2 型糖尿病（T2DM）的患者中，由特定代谢异常引起的脂肪肝可诊断为代谢相关脂肪性肝病（MAFLD）。然而，代谢紊乱的表现之一高尿酸血症（HUA）并未被纳入诊断标准。本研究旨在探讨非肥胖且无 T2DM 的患者中 HUA 与 MAFLD 的相关性。该研究共纳入了 2018 年至 2022 年期间来自中日友好医院体检中心的 28187 名参与者，将其分为四组：非肥胖且无 T2DM 组、肥胖且无 T2DM 组、非肥胖且有 T2DM 组和肥胖且有 T2DM 组。MAFLD 通过超声结合实验室检查进行诊断。采用 Logistic 回归分析 HUA 与 MAFLD 亚组之间的关系，采用受试者工作特征（ROC）曲线评估 UA 对 MAFLD 亚组的预测能力。HUA 与非肥胖且无 T2DM 患者的 MAFLD 之间呈正相关，无论男性还是女性，且在校正性别、BMI、血脂异常和肝功能异常后仍如此。这种相关性随着年龄的增长而逐渐增加，尤其是在 40 岁以上的人群中。HUA 是非肥胖且无 T2DM 患者 MAFLD 的独立危险因素。我们建议，在诊断非肥胖且无 T2DM 的 MAFLD 时，应考虑 UA 异常。HUA 是该人群 MAFLD 的独立危险因素。HUA 与非肥胖且无 T2DM 患者的 MAFLD 之间的相关性随着年龄的增长而逐渐增加，尤其是在 40 岁以上的人群中。在非肥胖且无 T2DM 的患者中，单因素分析显示，患有 HUA 的女性发生 MAFLD 的风险高于男性。然而，在校正混杂因素后，这种差异缩小了。
