title: Association between serum uric acid and nonalcoholic fatty liver disease in the US population.
abstract: OBJECTIVE
  Studies conducted in Eastern Asia suggest that serum uric acid (SUA) level is highly related to nonalcoholic fatty liver disease (NAFLD). However, limited information is available in the USA. Our objective was to determine the association between NAFLD and SUA levels in the USA and to determine if this is independent of age, sex, and components of metabolic syndrome (MetS).
  
  
  METHODS
  We analyzed 5370 men and women aged 20-74 years from the Third National Health and Nutrition Examination Survey (NHANES III) (1988-1994) in the USA. We calculated the prevalence and odds ratio (OR) of NAFLD and elevated liver enzymes by SUA and sex-specific quintiles of SUA, adjusting for multiple factors.
  
  
  RESULTS
  The prevalence of NAFLD was higher in participants with higher SUA levels (10.9%, 9.6%, 15.9%, 21.8% and 33.1%, respectively, from the second to the fifth sex-specific quintile of uric acid). After adjustment, individuals with hyperuricemia were more likely to have NAFLD (OR: 1.4, 95% CI: 1.1-1.9). Similarly, the adjusted odds of NAFLD were increasingly higher from the second to the fifth quintile of SUA (ORs: 0.8, 1.2, 1.5 and 1.7, respectively; p < 0.01) as compared to the lowest quintile. Finally, individuals with hyperuricemia were more likely to have elevated liver enzymes (aspartate aminotransferase or alanine aminotransferase) (adjusted OR: 1.8, 95% CI: 1.1-2.7).
  
  
  CONCLUSIONS
  NAFLD and SUA levels were strongly and independently associated in this nationally representative sample of men and women after adjustment for multiple factors.
authors.affiliation: Department of Family Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Shih
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Mariana
authors.initials: M
authors.lastname: Lazo
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Su-Hsun
authors.initials: SH
authors.lastname: Liu
authors.affiliation: Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bonekamp
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Washington Hospital Center/Georgetown University Hospital, Washington, DC, USA.
authors.forename: Ruben
authors.initials: R
authors.lastname: Hernaez
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, USA. Electronic address: jmclark@jhmi.edu.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Clark
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D005260:Female; D006801:Humans; D033461:Hyperuricemia / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D009749:Nutrition Surveys; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood*; D055815:Young Adult
chemical_list: D014527:Uric Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: hyperuricemia; nonalcoholic fatty liver disease; serum uric acid
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