Yang Xinyi, Lin Yan, Huang Jiaofeng, Chi Yujing, Wu Yinlian, Lin Su
Department of Hepatology, Hepatology Research Institute, the First Affiliated Hospital, Fujian Medical University, No. 20, Chazhong Road, Taijiang District, Fuzhou, 350005, Fujian, China.
Fujian Clinical Research Center for Liver and Intestinal Diseases, Fuzhou, 350002, Fujian, China.
Sci Rep. 2024 Mar 11;14(1):5923. doi: 10.1038/s41598-024-55845-5.
Uric acid (UA) is associated with non-alcoholic fatty liver disease (NAFLD). However, it is unclear whether UA plays a predictive role in NAFLD prognosis. This study aimed to explore the relationship between UA levels and mortality in NAFLD patients without severe renal disease. Data were obtained from the Third National Health and Nutrition Examination Survey (NHANES). Time-dependent Cox regression was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for mortality. Overall, 2493 individuals with NAFLD and estimated glomerular filtration rate (eGFR) > 60 mL/min/1.73 m were included in this study. The median follow-up period was 26.58 years. Patients were divided into high and low-UA groups according to UA levels. Time-independent Cox regression showed that UA level was not an independent risk factor for mortality in NAFLD patients without decreased eGFR (P > 0.05). After matching for age and sex using the propensity score matching method, UA remained not independently associated with death in NAFLD patients (P > 0.05). Similar results were found for cardiovascular-related and cancer-related deaths. Although UA is closely related to NAFLD, UA levels are not independently associated with the long-term survival of patients with NAFLD without decreased eGFR.
尿酸(UA)与非酒精性脂肪性肝病(NAFLD)相关。然而,尚不清楚UA在NAFLD预后中是否起预测作用。本研究旨在探讨无严重肾脏疾病的NAFLD患者尿酸水平与死亡率之间的关系。数据来自第三次全国健康和营养检查调查(NHANES)。采用时间依赖性Cox回归估计死亡率的风险比(HR)和95%置信区间(CI)。本研究共纳入2493例非酒精性脂肪性肝病患者,估计肾小球滤过率(eGFR)>60 mL/min/1.73 m²。中位随访期为26.58年,并根据尿酸水平将患者分为高尿酸组和低尿酸组。非时间依赖性Cox回归显示,在eGFR未降低的NAFLD患者中,尿酸水平不是死亡率的独立危险因素(P>0.05)。使用倾向评分匹配法对年龄和性别进行匹配后,尿酸水平仍与NAFLD患者的死亡无独立相关性(P>0.05)。在心血管相关死亡和癌症相关死亡方面也发现了类似的结果。尽管尿酸与非酒精性脂肪性肝病密切相关,但在eGFR未降低的非酒精性脂肪性肝病患者中,尿酸水平与长期生存无独立相关性。