Correlation analysis between serum uric acid level and the severity of non-alcoholic fatty liver disease in obese people.

doi:10.3877/cma.j.issn.2095-9605.2021.04.003

Abstract

Abstract:

Objective

To explore the risk factors of hyperuricemia in obese patients and the correlation between serum uric acid levels and the severity of non-alcoholic fatty liver disease at a clinical level.

Methods

From July 2018 to Sep 2020, a study was conducted retrospectively on 247 obesity patients who underwent bariatric surgery in the Nanjing Drum Tower Hospital. The patient's general information and serum and the liver NAS activity score were collected before surgery.

Results

221 patients were involved in the analysis of risk factors for hyperuricemia, including 57 (25.8%) in the hypouric acid group and 164 (74.2%) in the hyperuric acid group. The hyperuric acid group had higher BMI, younger age; there are also differences between the levels of ALT, AST, γ-GT, TBil, TG, HDL-C, LDL-C, insulin, and C-peptide. 141 patients had complete pathological results, of which 40 cases could exclude NASH, 68 cases could be NASH, and 33 cases could be diagnosed as NASH. The incidence of hyperuricemia in different groups was 78.7%, 76.5%, 47.5%. Multivariate logistic regression analysis suggests that the three groups have differences in intralobular inflammation, ballooning, ALT and UA levels (P<0.05); and the serum uric acid level is positive correlated with the liver steatosis (r=0.38, P<0.05), while no significant correlation with ballooning and intralobular inflammation (ballooning: r=0.14, P=0.096; intralobular inflammation: r=0.058, P=0.493).

Conclusions

As the increase of BMI in obese patients, the possibility of hyperuricemia and non-alcoholic fatty liver disease increase; young and male patients seem to be easier suffering from hyperuricemia; the increase of serum uric acid also promotes the development of non-alcoholic fatty liver disease in obese patients, and the level of blood uric acid is correlated with the degree of liver steatosis.

Key words: Obesity, Uric acid, Hyperuricemia, Non-alcoholic fatty liver disease

Yuze Shi, Xiaodong Shan, Xuehui Chu, Saisai Zhu, Xitai Sun. Correlation analysis between serum uric acid level and the severity of non-alcoholic fatty liver disease in obese people.[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2021, 07(04): 232-238.

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References 21

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项目		总人数（n=221）
性别
	男	86（38.91%）
	女	135（61.09%）
合并糖耐量异常或糖尿病		122（55.20%）
合并高血压		98（44.34%）
合并高血脂		135（61.09%）
合并胰岛素抵抗		205（92.76%）
BMI（median [IQR]，kg/m²）		38.42 [34.89, 43.24]
ALT（median [IQR]，U/L）		43.60 [25.40, 79.10]
AST（median [IQR]，U/L）		27.40 [18.50, 45.70]
γ-GT（median [IQR]，U/L）		40.20 [26.60, 64.20]
TBil（median [IQR]，μmol/L）		10.00 [8.00, 12.90]
Glu（median [IQR]，mmol/L）		5.28 [4.77, 6.24]
TG（median [IQR]，mmol/L）		1.71 [1.24, 2.25]
TB（median [IQR]，mmol/L）		4.74 [4.18, 5.39]
HDL-C（median [IQR]，mmol/L）		1.00 [0.85, 1.16]
LDL-C（median [IQR]，mmol/L）		2.94 [2.44, 3.45]
INS（median [IQR] ，μU/mL）		26.90 [19.04, 37.88]
C-peptide（median [IQR] ，pmol/L）		1365.00 [1081.00, 1711.00]
HbA1c（median [IQR]，%）		5.80 [5.50, 6.50]

项目		总人数（n=221）
性别
	男	86（38.91%）
	女	135（61.09%）
合并糖耐量异常或糖尿病		122（55.20%）
合并高血压		98（44.34%）
合并高血脂		135（61.09%）
合并胰岛素抵抗		205（92.76%）
BMI（median [IQR]，kg/m²）		38.42 [34.89, 43.24]
ALT（median [IQR]，U/L）		43.60 [25.40, 79.10]
AST（median [IQR]，U/L）		27.40 [18.50, 45.70]
γ-GT（median [IQR]，U/L）		40.20 [26.60, 64.20]
TBil（median [IQR]，μmol/L）		10.00 [8.00, 12.90]
Glu（median [IQR]，mmol/L）		5.28 [4.77, 6.24]
TG（median [IQR]，mmol/L）		1.71 [1.24, 2.25]
TB（median [IQR]，mmol/L）		4.74 [4.18, 5.39]
HDL-C（median [IQR]，mmol/L）		1.00 [0.85, 1.16]
LDL-C（median [IQR]，mmol/L）		2.94 [2.44, 3.45]
INS（median [IQR] ，μU/mL）		26.90 [19.04, 37.88]
C-peptide（median [IQR] ，pmol/L）		1365.00 [1081.00, 1711.00]
HbA1c（median [IQR]，%）		5.80 [5.50, 6.50]

		低尿酸	高尿酸	P值
n		57	164
性别
	男	12（21.05%）	74（45.12%）	0.002
	女	45（78.95%）	90（54.88%）
年龄（median [IQR]）		36.00 [31.00, 45.00]	30.00 [24.00, 37.00]	<0.001
合并糖耐量异常或糖尿病		35（61.40%）	87（53.05%）	0.348
合并高血压		23（40.35%）	75（45.73%）	0.583
合并高血脂		32（56.14%）	103（62.80%）	0.465
合并胰岛素抵抗		51（89.47%）	154（93.90%）	0.415
BMI（median [IQR] ，kg/m²）		35.03 [32.24, 39.56]	39.47 [35.83, 43.88]	<0.001
ALT（median [IQR] ，U/L）		32.40 [22.20, 63.10]	48.45 [26.55, 81.88]	0.042
AST（median [IQR] ，U/L）		23.50 [17.40, 34.20]	33.50 [19.40, 48.82]	0.036
γ-GT（median [IQR] ，U/L）		30.10 [23.90, 52.80]	42.00 [28.48, 67.12]	0.009
TBil（median [IQR] ，μmol/L）		9.10 [7.40, 11.30]	10.50 [8.20, 13.93]	0.009
Glu （median [IQR] ，mmol/L）		5.33 [4.92, 6.51]	5.25 [4.73, 6.06]	0.153
TG （median [IQR] ，mmol/L）		1.57 [1.02, 2.08]	1.82 [1.30, 2.36]	0.021
TB （median [IQR] ，mmol/L）		4.62 [4.14, 5.43]	4.79 [4.23, 5.35]	0.557
HDL-C（median [IQR] ，mmol/L）		1.06 [0.89, 1.23]	0.98 [0.84, 1.11]	0.006
LDL-C（median [IQR] ，mmol/L）		2.85 [2.43, 3.41]	2.98 [2.47, 3.45]	0.643
INS （median [IQR] ，μU/mL）		22.83 [16.41, 31.17]	28.89 [21.20, 38.47]	0.005
C-peptide （median [IQR] ，pmol/L）		1216.00 [939.30, 1463.00]	1439.00 [1126.00, 1750.00]	<0.001
HbA1c （median [IQR]，%）		6.00 [5.60, 6.50]	5.80 [5.40, 6.50]	0.286

		低尿酸	高尿酸	P值
n		57	164
性别
	男	12（21.05%）	74（45.12%）	0.002
	女	45（78.95%）	90（54.88%）
年龄（median [IQR]）		36.00 [31.00, 45.00]	30.00 [24.00, 37.00]	<0.001
合并糖耐量异常或糖尿病		35（61.40%）	87（53.05%）	0.348
合并高血压		23（40.35%）	75（45.73%）	0.583
合并高血脂		32（56.14%）	103（62.80%）	0.465
合并胰岛素抵抗		51（89.47%）	154（93.90%）	0.415
BMI（median [IQR] ，kg/m²）		35.03 [32.24, 39.56]	39.47 [35.83, 43.88]	<0.001
ALT（median [IQR] ，U/L）		32.40 [22.20, 63.10]	48.45 [26.55, 81.88]	0.042
AST（median [IQR] ，U/L）		23.50 [17.40, 34.20]	33.50 [19.40, 48.82]	0.036
γ-GT（median [IQR] ，U/L）		30.10 [23.90, 52.80]	42.00 [28.48, 67.12]	0.009
TBil（median [IQR] ，μmol/L）		9.10 [7.40, 11.30]	10.50 [8.20, 13.93]	0.009
Glu （median [IQR] ，mmol/L）		5.33 [4.92, 6.51]	5.25 [4.73, 6.06]	0.153
TG （median [IQR] ，mmol/L）		1.57 [1.02, 2.08]	1.82 [1.30, 2.36]	0.021
TB （median [IQR] ，mmol/L）		4.62 [4.14, 5.43]	4.79 [4.23, 5.35]	0.557
HDL-C（median [IQR] ，mmol/L）		1.06 [0.89, 1.23]	0.98 [0.84, 1.11]	0.006
LDL-C（median [IQR] ，mmol/L）		2.85 [2.43, 3.41]	2.98 [2.47, 3.45]	0.643
INS （median [IQR] ，μU/mL）		22.83 [16.41, 31.17]	28.89 [21.20, 38.47]	0.005
C-peptide （median [IQR] ，pmol/L）		1216.00 [939.30, 1463.00]	1439.00 [1126.00, 1750.00]	<0.001
HbA1c （median [IQR]，%）		6.00 [5.60, 6.50]	5.80 [5.40, 6.50]	0.286

NAFLD		（0，1，2）	（3,4）	（5,6）	adjusted-OR	P-值
n		40	68	33
性别（%）
	男	13 （32.50）	18 （26.47）	18 （54.55）	1
	女	27 （67.50）	50 （73.53）	15 （45.45）	2.404（0.983-5.879）	0.055
气球样变（%）
	0	18 （45.00）	21 （30.88）	1 （3.03）	1
	1	22 （55.00）	46（67.65）	30 （90.91）	10.556（3.904-28.538）	<0.001
	2	0（0.00）	1（1.47）	2（6.06）	-	-
小叶内炎症（%）
	0	24 （60.00）	16 （23.53）	0 （0.00）	1
	1	16 （40.00）	49 （72.06）	25 （75.76）	31.296（10.521-93.091）	<0.001
	2	0（0.00）	3（4.41）	8（24.24）	-	-
年龄（median [IQR]）		31.00 [23.75, 38.00]	31.00 [26.00, 39.00]	31.00 [26.00, 38.00]	1.004（0.963-1.046）	0.865
ALT （median [IQR] ，U/L）		29.35 [19.25, 43.07]	41.25 [24.27, 70.45]	67.70 [44.90, 107.30]	1.019（1.009-1.028）	<0.001
尿酸（median [IQR]，μmol/L）		370.00 [322.50, 478.00]	453.00 [398.00, 511.50]	515.00 [453.00, 557.00]	1.009（1.004-1.013）	<0.001

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