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Background:The association between the serum uric acid (sUA) to creatinine ratio (sUA/Cr) and non-alcoholic fatty liver disease (NAFLD) has not been sufficiently clarified. In this study, we investigated the relationship between sUA/Cr and NAFLD among participants in the United States. Methods:We performed a cross-sectional study based on data from the National Health and Nutrition examination Survey (NHANES) 2017-2018. A measured controlled attenuation parameter (CAP) value of ≥274 dB/m detected by Fibroscan was used to identify hepatic steatosis. SUA/Cr was calculated as sUA divided by serum creatinine. Multivariate logistic regression analysis was used to estimate the association between sUA/Cr and NAFLD. The adjusted odds ratio (OR) of sUA/Cr for NAFLD was estimated, and subgroup analysis stratified by sex was also conducted. The nonlinear relationship between sUA/Cr and NAFLD was further described using smooth curve fittings and threshold-effect analysis. Results:We found that sUA/Cr was positively correlated with NAFLD status after fully adjustment for confounding factors. In subgroup analysis stratified by sex, the positive interaction between sUA/Cr and NAFLD status only existed in women but not in men. Moreover, the nonlinear association between sUA/Cr and NAFLD status was an inverted U-shaped curve with an inflection point at 9.7 among men. Conclusions:Our study identified that sUA/Cr was positively associated with the risk of NAFLD among individuals in the United States. Moreover, the correlation between sUA/Cr and NAFLD differed according to sex.

Object: To explore the association between cardiometabolic index(CMI) and non-alcoholic fatty liver disease (NAFLD) detected by Fibroscan in Americans. Methods: A total of 2054 participants from the National Health and Nutrition Examination Survey (NHANES) 2017-2018 were included in this cross-sectional analysis. The diagnosis of NAFLD was based on the following criteria: controlled attenuation parameter(CAP) value≥274 dB/m indicating liver steatosis and exclusion of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection and excessive alcohol consumption. The relationship between CMI and NAFLD was assessed using a weighted multivariable logistic regression. Subgroup analyses stratified by gender, race, and BMI were further conducted. Results: A total of 796 (38.8%) participants were confirmed with NAFLD. CMI was significantly higher in NAFLD group than that in non-NAFLD group (P<0.001). In all the three regression models, CMI were positively associated with the prevalence of NAFLD (model 1: OR=6.76, 95% CI: 5.27 to 8.68; model 2: OR=5.54, 95% CI: 4.30 to 7.14; model 3: OR=2.13, 95% CI: 1.65 to 2.76). After stratified by gender, race and BMI, the positive correlations existed steadily in different subgroups. The smooth curve fit showed an inverted U-shaped association between CMI and the prevalence of NAFLD. Conclusion: CMI was positively correlated with the prevalence of NAFLD in the general American population. Moreover, the positive relationship between CMI and NAFLD existed steadily after stratified by gender, race, and BMI.