The association between serum uric acid to high density lipoprotein-cholesterol ratio and non-alcoholic fatty liver disease: the abund study

Kösekli, Mehmet Ali; Kurtkulagii, Ozge; Kahveci, Gizem; Duman, Tuba Taslamacıoğlu; Tel, Burçin Meryem Atak; Bilgin, Satılmış; Demirkol, Muhammed Emin; Aktas, Gülali

doi:10.1590/1806-9282.20201005

Cited by 59 publications

(42 citation statements)

References 26 publications

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“…Kosekli et al proposed that UHR might serve as a novel and reliable marker for NAFLD. This was consistent with the main results of this study, but we focus on the association between non-obese patients with normal lipid levels and the prevalence of NAFLD [3] . Recently, a new terminology, metabolic dysfunction-associated fatty liver disease (MAFLD), has been widely discussed.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Zhu

Shi

et al. 2021

Preprint

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Background: Nonalcoholic fatty liver disease (NAFLD) is commonly occurred in the non-obese individuals. The serum uric acid (UA) to high-density lipoprotein cholesterol (HDL-c) ratio (UHR) is considered as a predictive factor of NAFLD. However, it is still difficult to confirm the correlation in lean Chinese people with normal blood lipid levels. It is aimed to analyze the correlation of UHR with NAFLD among lean Chinese population without dyslipidemia and compared UHR with other predictors in this study.Methods: 9838 lean people without NAFLD were included in a retrospective cohort study. NAFLD was diagnosed by liver ultrasound.Results: A total of 9,838 lean patients with normal blood lipid levels were included in the final study. During the five-year follow-up period, the overall prevalence of NAFLD was 8.7%. across the quintile 1, 2, 3, 4 and 5 of UHR, the prevalence of NAFLD among lean patients was increased from 2.4%, 5%, 7.9%, 10.3% to 17.8%. After adjustment for age, markers of liver and kidney function, gender and metabolic indicators, multivariate cox proportional hazard regression analysis demonstrated that the hazard ratio(HR) was 1.99(1.43-2.73) in highest UHR (quintile 5) compared with lowest UHR(quintile 1). The area under the curve(AUC) of UHR (0.690) was higher than in UA (0.666) and HDL-c (0.636), which showed that the predictive ability of the UHR to new-onset NAFLD was better than serum uric acid and HDL-c. Even within the normal range of UA and HDL-c levels, UHR was independently associated with NAFLD, and HR (95% confidence interva, 95%CI) for NAFLD in Quintile 5 of UHR was 6.74(4.32-10.53). Compared with other significant predictors, the AUC value of UHR(0.67) was similar to that of low-density lipoprotein cholesterol(LDL-c)/HDL-c ratio(0.68), non-high-density lipoprotein cholesterol (NHDL-c)/HDL-c ratio(0.68) and alanine aminotransferase (ALT)/ aspartate aminotransferase (AST) ratio(0.7), and superior to that of LDL-c (0.63), remnant cholesterol (RC,0.59), albumin(ALB)/alkaline phosphatase(ALP) ratio(0.61). The sensitivity of UHR (70.5%) was the highest among all indicators. In the subgroup of ALT, the AUC of UHR was 0.70, which was the highest among all predictors in subjects with ALT< 40. For subjects with elevated ALT levels (ALT > 40 U/L), there was no statistical significance among RC (P=0.441), ALB/ALP (P=0.419) and ALT/AST(P=0.159). In contrast, UHR's performance in predicting NAFLD was meaningful and reliable (AUC=0.61, p<0.001).Conclusions: UHR serve as an inexpensive and reliable predictor of NAFLD in lean Chinese people with normal blood lipid levels. It can be used to identify people at high risk of NAFLD.

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Section: Discussionsupporting

confidence: 91%

“…NAFLD is characterized by lipid deposits in liver cells, including hepatic steatosis, steatohepatitis, brosis and cirrhosis [2] . It affects nearly a third of adults worldwide and is particularly severe in developed countries [3] . NAFLD has become a new challenge for China.…”

Section: Introductionmentioning

confidence: 99%

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Zhu

Shi

et al. 2021

Preprint

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“…16 In Kocak et al’s (2019) 17 study, the use of UHR as an effective tool to diagnose metabolic syndrome in patients with type 2 diabetes has been proposed. UHR also used as a marker that is significantly associated with FPG and HbA1c levels to assess the control of type 2 diabetes in men, 18 hepatic steatosis, 19 Hashimoto's thyroiditis 16 and non‐alcoholic fatty liver disease. 20 …”

Section: Background and Objectivesmentioning

confidence: 99%

Investigating the relationship between serum uric acid to high‐density lipoprotein ratio and metabolic syndrome

Yazdi

Baghaei

Baniasad

et al. 2021

Endocrino Diabet & Metabol

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Aims This study aimed to determine a parameter to more easily diagnose metabolic syndrome and predict its probability of occurrence in high‐risk individuals. Methods In this cross‐sectional study, data related to the study population in the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS) were examined. Subjects were divided into two groups with and without metabolic syndrome, and the relevant factors such as the ratios of uric acid to high‐density lipoprotein (HDL) (UHR) in these two groups were compared, and the best cut‐off point was determined. Results Data related to 817 people including 96 people with metabolic syndrome and 721 people without metabolic syndrome were analysed. The mean UHR was significantly higher in patients with metabolic syndrome (14.76 ± 6.33%) compared with those without metabolic syndrome (10.0 ± 3.10%) (p < .001). People with high UHR are 2.9 times more at risk of metabolic syndrome and the best cut‐off point was 9.50% with 86% sensitivity and 55% specificity. Conclusions According to our study, UHR is also helpful in diagnosing metabolic syndrome and can also be used to screen people at risk for metabolic syndrome.

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“…Relevant studies have shown that an elevated SUA is positively correlated with gout, kidney disease, atherosclerosis, hypertension, stroke and cardiovascular diseases 3,4 . In addition, elevated SUA is also related to glycated haemoglobin (HbA1c) levels in type 2 diabetes mellitus (T2DM), metabolic syndrome, hepatosteatosis, thyroiditis and diabetic kidney disease 5–9 . Hyperuricaemia is frequently observed in patients with T2DM because of the impaired renal excretion of uric acid associated with insulin resistance and hyperinsulinaemia 10 .…”

Section: Introductionmentioning

confidence: 99%

“…disease. [5][6][7][8][9] Hyperuricaemia is frequently observed in patients with T2DM because of the impaired renal excretion of uric acid associated with insulin resistance and hyperinsulinaemia. 10 The prevalence of hyperuricaemia in patients with T2DM with central obesity is more than 30%, which is much higher than that in the general population.…”

mentioning

confidence: 99%

Effects of sodium‐glucose cotransporter 2 inhibitors on serum uric acid in patients with type 2 diabetes mellitus: A systematic review and network meta‐analysis

Yang

Jia

et al. 2021

Diabetes Obesity Metabolism

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Aims The present study aims to determine the effects of sodium‐glucose cotransporter 2 (SGLT‐2) inhibitors on the serum uric acid (SUA) levels of patients with type 2 diabetes mellitus (T2DM) in Asia. Methods PubMed, CENTRAL, Embase and Cochrane Library databases were searched for randomized controlled trials of SGLT‐2 inhibitors in patients with T2DM up to 15 July 2021, without language or date restrictions. Results In total, 19 high‐quality studies (4218 participants) were included in the present network meta‐analysis. All of the included SGLT‐2 inhibitors (empagliflozin, dapagliflozin, canagliflozin, ipragliflozin, luseogliflozin and tofogliflozin) significantly decreased SUA levels compared with those of the control [total standard mean difference –0.965, 95% CI (−1.029, −0.901), p = .000, I2 = 98.7%] in patients with T2DM. Subgroup analysis and meta‐regression showed that the combined analysis of different inhibitors might lead to heterogeneity of the results. Therefore, among the SGLT‐2 inhibitors, the results of the subsequent network meta‐analysis revealed that luseogliflozin and dapagliflozin ranked the highest in terms of lowering SUA levels among the SGLT‐2 inhibitors. Moreover, the network meta‐analysis declared that luseogliflozin (1 and 10 mg) and dapagliflozin (5 mg) led to a superior reduction in SUA in patients with T2DM. Conclusions SGLT‐2 inhibitors could significantly reduce SUA levels in patients with T2DM, particularly luseogliflozin (1 and 10 mg) and dapagliflozin (5 mg) possess the best effects. Therefore, SGLT‐2 inhibitors look extremely promising as an antidiabetes treatment option in patients with T2DM with high SUA.

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The association between serum uric acid to high density lipoprotein-cholesterol ratio and non-alcoholic fatty liver disease: the abund study

Cited by 59 publications

References 26 publications

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Investigating the relationship between serum uric acid to high‐density lipoprotein ratio and metabolic syndrome

Effects of sodium‐glucose cotransporter 2 inhibitors on serum uric acid in patients with type 2 diabetes mellitus: A systematic review and network meta‐analysis

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