title: Serum uric acid is independently and linearly associated with risk of nonalcoholic fatty liver disease in obese Chinese adults.
abstract: The present study aimed to explore the independent association and potential pathways between serum uric acid (SUA) and nonalcoholic fatty liver disease (NAFLD). 1365 community-living obese Chinese adults who received hepatic ultrasonography scanning were included. The prevalence rates of NAFLD were 71.5% for men and 53.8% for women. Compared with controls, NAFLD subjects showed significantly increased SUA levels (333.3 ± 84.9 v.s. 383.4 ± 93.7 μmol/L) and prevalence rate of hyperuricemia (HUA) (25.7% v.s. 47.3%, p < 0.001). After adjustment for insulin resistance (IR), components of metabolic syndrome (MetS) and other potential confounders, elevated SUA is independently associated with increased risk of NAFLD, with the adjusted OR of 1.528-2.031 (p < 0.001). By using multivariable fractional polynomial (MFP) modeling, the best FP transformation model shows that SUA was independently and linearly associated with risk of NAFLD. The one-pathway model by using structural equation modeling (SEM) about the relationships among SUA, IR, components of metabolic syndrome and NAFLD fits well (χ2= 57.367, p < 0.001; CFI = 0.998; TLI = 0.992; and RMSEA = 0.048) and shows SUA might increase the risk of NAFLD directly besides of the indirect effects through increasing fasting insulin, blood pressure, triglyceride and decreasing HDL-C levels. Our results imply that elevated SUA may play an important role in NAFLD pathogenesis.
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.
authors.forename: Chang-Qin
authors.initials: CQ
authors.lastname: Liu
authors.affiliation: Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Chun-Mei
authors.initials: CM
authors.lastname: He
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Chen
authors.affiliation: School of Public Health, Xiamen University, Xiamen, China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.
authors.forename: Xiulin
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.
authors.forename: Yongwen
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zeng
authors.affiliation: Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Yan
authors.affiliation: Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Suhuan
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.|Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Shuyu
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.|Xiamen Diabetes Institute, Xiamen, China.|Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Diabetes, the First Affiliated Hospital, Xiamen University, Xiamen, China.|Xiamen Diabetes Institute, Xiamen, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Li
authors.affiliation: Xiamen Diabetes Institute, Xiamen, China.|School of Public Health, Xiamen University, Xiamen, China.|Epidemiology Research Unit, the First Affiliated Hospital, Xiamen University, Xiamen, China.
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Li
mesh_terms: D000368:Aged; D015415:Biomarkers; D002681:China / Q000453:epidemiology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D053858:Metabolic Networks and Pathways; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D009765:Obesity / Q000097:blood* / Q000150:complications*; D016017:Odds Ratio; D012306:Risk; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D014527:Uric Acid