Association between serum uric acid-to-creatinine ratio and non-alcoholic fatty liver disease: a cross-sectional study in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol

Wang, Xiaoyu; Han, Yong; Liu, Yuanyuan; Hu, Haofei

doi:10.1186/s12876-022-02500-w

Cited by 6 publications

(9 citation statements)

References 78 publications

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“…In a previous study, Seo and Han [ 20 ] revealed a post-correction OR of sUA/sCr in NAFLD as 0.182 (95% CI: 1.066–1.311, p = 0.002), while Ma et al [ 22 ] reported a post-correction OR of sUA/sCr in NAFLD as 1.529 (95% CI: 1.011–2.310, p = 0.044). Wang et al [ 21 ] reported that there was a nonlinear relationship between sUA/sCR and NAFLD risk and that when sUA/sCR was less than 4.425, the OR was 1.551 (95% CI: 1.504–1.599) and the AUC was 0.624 (95% CI: 0.6589–0.6660) with 64.8% sensitivity and 59.8% specificity. However, these studies had limitations in that ultrasound, which is the most widely used modality for fatty liver diagnosis today, was not used or targeted for Koreans.…”

Section: Discussionmentioning

confidence: 99%

The correlation between NAFLD and serum uric acid to serum creatinine ratio

Choi

Joe

et al. 2023

PLoS ONE

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Background With the prevalence of non-alcoholic fatty liver disease (NAFLD) increasing worldwide, many noninvasive techniques have been used to improve its diagnosis. Recently, the serum uric acid/creatinine (sUA/sCr) ratio was identified as an indicator of fatty liver disease. Therefore, we examined the relationship between sUA/sCr levels and ultrasound-diagnosed NAFLD in Korean adults. Methods This study included 16,666 20-year-olds or older who received health checkups at a university hospital’s health promotion center from January to December 2021. Among them, 11,791 non-patients with and without NAFLD were analyzed, excluding those without abdominal ultrasound, those without data on fatty liver, cancer, or chronic kidney disease severity, those with a history of alcohol abuse, and those with serum hs-CRP <5 mg/L. The odds ratio (OR) and 95% confidence interval (CI) of the sUA/sCr ratio according to the presence or absence of fatty liver disease and severity were calculated after correcting for confounding variables using logistic regression analysis. The receiver operating characteristic (ROC) curve and area under the curve (AUC) of the sUA/sCr ratio confirmed and compared the sensitivity and specificity of NAFLD and serum uric acid. Results sUA/sCr increased with fatty liver severity, and the post-correction OR in the NAFLD group was 1.183 (95% CI: 1.137–1.231) compared to the group without NAFLD. Concerning the fatty liver severity, the post-correction OR in the mild NAFLD group increased to 1.147 (95% CI: 1.099–1.196), and that in the moderate-to-severe NAFLD group increased to 1.275 (95% CI: 1.212–1.341) compared to the group without NAFLD. The sensitivity of sUA/sCr to fatty liver severity was 57.9% for the non-NAFLD group, 56.7% for the mild NAFLD group, and 59.0% for the moderate-to-severe NAFLD group; the specificity of sUA/sCr to fatty liver severity 61.4% for the non-NAFLD group, 57.3% for the mild NAFLD group, and 65.2% for the moderate-to-severe NAFLD group. Conclusion NAFLD severity is associated with sUA/sCR.

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Section: Discussionmentioning

confidence: 99%

The correlation between NAFLD and serum uric acid to serum creatinine ratio

Choi

Joe

et al. 2023

PLoS ONE

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“…Previous studies have reported that SUA/Cr ratio is associated with many diseases, such as metabolic syndrome in postmenopausal women, 21 diabetic kidney disease in patients with type 2 diabetes, 22 and nonalcoholic fatty liver disease in Chinese people without obesity with normal low-density lipoprotein cholesterol values. 23 All these conditions are known to be risk factors for CVD. 24 - 27 The positive correlation between SUA/Cr ratio and CVD was also identified in 2 prospective studies with 96,378 participants 11 and 20,724 participants, 10 respectively.…”

Section: Discussionmentioning

confidence: 99%

Does Serum Uric Acid to Creatinine Ratio Predict Mortality Risk in Patients With Heart Failure?

Xi,

Cai,

Zhang

et al. 2024

Texas Heart Institute Journal

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Background: Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF. Methods: This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed using the Cox proportional hazards model. Results: The mean (SD) age and mean (SD) SUA/Cr ratio of the study cohort (66% male) were 59.3 (14.7) years and 4.71 (2.09), respectively. During a median follow-up period of 15 months (range, 11-26 months), 390 end-point events were observed. Prognosis analysis revealed that a high SUA/Cr ratio was associated with an increased mortality risk of HF (hazard ratio, 1.62 [95% CI, 1.26-2.09]; P < .001) compared with the SUA/Cr ratio in the lowest tertile. After adjusting for covariates, the hazard ratio for mortality risk of HF was 1.71 (95% CI, 1.23-2.37; P = .001). Subgroup analysis showed that mortality risk increased in direct proportion with the SUA/Cr ratio in female patients, patients with a history of hypertension and β-blocker use, and patients with UA levels below 428 μmol/L and creatinine levels less than 97 mg/dL. Stratification by age; by history of diabetes, hyperlipidemia, and smoking; and by level of fasting plasma glucose, however, had no obvious effect on the association between SUA/Cr ratio and HF prognosis. Patients with higher SUA/Cr ratios had reduced left ventricular ejection fraction and increased left ventricular end-diastolic diameter. Conclusion: A high SUA/Cr ratio was an independent risk factor for the mortality risk of HF.

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“…[ 16 ]. Based on the study population, these association studies were most regularly reported in East Asian populations, particularly in China [ 22 , 23 ]. The multiracial and multicultural nation’s NHANES database shows a representatively larger population.…”

Section: Discussionmentioning

confidence: 99%

Association of serum uric acid with hepatic steatosis detected by controlled attenuation parameter in the United States population

et al. 2023

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Background 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. Methods 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. Results 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). Conclusions 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.

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Association between serum uric acid-to-creatinine ratio and non-alcoholic fatty liver disease: a cross-sectional study in Chinese non-obese people with a normal range of low-density lipoprotein cholesterol

Cited by 6 publications

References 78 publications

The correlation between NAFLD and serum uric acid to serum creatinine ratio

The correlation between NAFLD and serum uric acid to serum creatinine ratio

Does Serum Uric Acid to Creatinine Ratio Predict Mortality Risk in Patients With Heart Failure?

Association of serum uric acid with hepatic steatosis detected by controlled attenuation parameter in the United States population

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