Endoscopy Center, The First People's Hospital of Kunshan, Kunshan, 215300, China.
Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Changshu, 215500, China.
Lipids Health Dis. 2023 Jun 20;22(1):76. doi: 10.1186/s12944-023-01846-8.
The relationship between serum uric acid (SUA) and nonalcoholic fatty liver disease (NAFLD) has been previously reported. Controlled attenuation parameter (CAP) has better diagnostic performance than ultrasonography for assessing hepatic steatosis. The association of SUA with hepatic steatosis detected by CAP is worth further study.
The US population aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) was assessed. Hepatic steatosis was evaluated by the controlled attenuation parameter (CAP). NAFLD status was defined as CAP values of 268 dB/m without hepatitis B or C virus infection or considerable alcohol consumption. Multiple imputations were performed to fill in the missing covariate values. Linear regression, logistic regression, and smooth curve fitting were used to examine the association.
In total, 3919 individuals participated in this study. There was a positive association between SUA (µmol/L) and CAP (β = 0.14, 95% CI: 0.12-0.17, P < 0.01). After stratification by sex, a significant relationship between SUA and CAP existed in both males (β = 0.12, 95% CI: 0.09-0.16, P < 0.01) and females (β = 0.17, 95% CI: 0.14-0.20, P < 0.01) after multiple imputation. The inflection points of the threshold effect of SUA on CAP were 487.7 µmol/L in males and 386.6 µmol/L in females. There was a positive association between SUA (mg/dL) and NAFLD (OR = 1.30, 95% CI: 1.23-1.37, P < 0.01). After stratification by race, positive relationships were also observed. Meanwhile, a positive relationship existed between hyperuricemia and NAFLD (OR = 1.94, 95% CI: 1.64-2.30, P < 0.01). The positive relationship was more significant in females than in males (P for interaction < 0.01).
There was a positive association between SUA and CAP, as well as between SUA and NAFLD. Subgroup studies stratified by sex and ethnicity demonstrated that the effects were consistent.
血清尿酸（SUA）与非酒精性脂肪性肝病（NAFLD）之间的关系先前已有报道。受控衰减参数（CAP）在评估肝脂肪变性方面比超声具有更好的诊断性能。SUA 与 CAP 检测到的肝脂肪变性之间的关联值得进一步研究。
评估了来自国家健康和营养检查调查（NHANES）的年龄在 20 岁或以上的美国人群。通过受控衰减参数（CAP）评估肝脂肪变性。NAFLD 状态定义为 CAP 值为 268dB/m 且无乙型或丙型肝炎病毒感染或大量饮酒史。采用多重插补法填补缺失的协变量值。采用线性回归、逻辑回归和光滑曲线拟合来检验相关性。
共 3919 人参与了这项研究。SUA（µmol/L）与 CAP（β=0.14，95%CI：0.12-0.17，P<0.01）呈正相关。按性别分层后，在男性（β=0.12，95%CI：0.09-0.16，P<0.01）和女性（β=0.17，95%CI：0.14-0.20，P<0.01）中，SUA 与 CAP 之间均存在显著关系，多重插补后。SUA 对 CAP 的阈值效应的拐点在男性为 487.7µmol/L，在女性为 386.6µmol/L。SUA（mg/dL）与 NAFLD 之间呈正相关（OR=1.30，95%CI：1.23-1.37，P<0.01）。按种族分层后，也观察到了正相关关系。同时，高尿酸血症与 NAFLD 之间存在正相关（OR=1.94，95%CI：1.64-2.30，P<0.01）。在女性中，这种正相关关系比男性更为显著（P 交互<0.01）。
SUA 与 CAP 之间以及 SUA 与 NAFLD 之间呈正相关。按性别和种族分层的亚组研究表明，这些影响是一致的。
