Year 2019 / Volume 111 / Number 4
Original
Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD)

264-269

DOI: 10.17235/reed.2019.5965/2018

Conrado M. Fernández Rodríguez, Rocío Aller, María Luisa Gutiérrez García, Javier Ampuero, Judith Gómez-Camarero, Rosa M.ª Martín-Mateos, Diego Burgos-Santamaría, José Miguel Rosales, Patricia Aspichueta, Xabier Buque, Mercedes Latorre, Raúl J. Andrade, Manuel Hernández-Guerra, Manuel Romero-Gómez,

Abstract
Background: recent evidence suggests a causal link between serum uric acid and the metabolic syndrome, diabetes mellitus, arterial hypertension, and renal and cardiac disease. Uric acid is an endogenous danger signal and activator of the inflammasome, and has been independently associated with an increased risk of cirrhosis. Aim and methods: six hundred and thirty-four patients from the nation-wide HEPAMET registry with biopsy-proven NAFLD (53% NASH) were analyzed to determine whether hyperuricemia is related with advanced liver damage in patients with non-alcoholic fatty liver disease (NAFLD). Patients were divided into three groups according to the tertile levels of serum uric acid and gender. Results: the cohort was composed of 50% females, with a mean age of 49 years (range 19-80). Patients in the top third of serum uric acid levels were older (p = 0.017); they had a higher body mass index (p < 0.01), arterial blood pressure (p = 0.05), triglyceridemia (p = 0.012), serum creatinine (p < 0.001) and total cholesterol (p = 0.016) and lower HDL-cholesterol (p = 0.004). According to the univariate analysis, the variables associated with patients in the top third were more advanced steatosis (p = 0.02), liver fibrosis (F2-F4 vs F0-1; p = 0.011), NASH (p = 0.002) and NAS score (p = 0.05). According to the multivariate logistic regression analysis, the top third of uric acid level was independently associated with steatosis (adjusted hazard ratio 1.7; CI 95%: 1.05-2.8) and NASH (adjusted hazard ratio 1.8; CI 95%: 1.08-3.0) but not with advanced fibrosis (F2-F4) (adjusted hazard ratio 1.09; CI 95%: 0.63-1.87). Conclusion: higher levels of serum uric acid were independently associated with hepatocellular steatosis and NASH in a cohort of patients with NAFLD. Serum uric acid levels warrants further evaluation as a component of the current non-invasive NAFLD scores of histopathological damage.
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Fernández Rodríguez C, Aller R, Gutiérrez García M, Ampuero J, Gómez-Camarero J, Martín-Mateos R, et all. Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD). 5965/2018


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Publication history

Received: 09/10/2018

Accepted: 27/01/2019

Online First: 27/02/2019

Published: 04/04/2019

Article revision time: 104 days

Article Online First time: 141 days

Article editing time: 177 days


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