title: Hyperuricemia is not associated with severity of liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Uric acid is a natural antioxidant. Previous studies have suggested a protective role of hyperuricemia against liver fibrosis among patients with nonalcoholic fatty liver disease (NAFLD). However, the results were conflicting.
  
  
  METHODS
  MEDLINE and EMBASE databases were searched through August 2016 for studies that investigated the association between hyperuricemia and fibrosis stage among patients with biopsy-proven NAFLD. Pooled odds ratio and 95% confidence interval were calculated using a random-effects model, generic inverse variance method of DerSimonian and Laird. The between-study heterogeneity of effect size was quantified using the Q statistic and I.
  
  
  RESULTS
  A total of five observational studies with 749 NAFLD patients were identified. Patients with NAFLD who had hyperuricemia were not significantly more likely or less likely to have advanced liver fibrosis (defined as fibrosis stage of ≥3) compared with patients with NAFLD who had normal serum uric with the pooled odds ratio of 0.72 (95% confidence interval: 0.34-1.53). The statistical heterogeneity was low with an I of 22% (Pheterogeneity=0.27).
  
  
  CONCLUSIONS
  Significant protective role of hyperuricemia against the development of advanced liver fibrosis in patients with NAFLD was not observed in this meta-analysis.
authors.affiliation: aDepartment of Internal Medicine, University of Hawaii, Honolulu, Hawaii bDepartment of Internal Medicine, Norwalk Hospital, Norwalk, Connecticut cDepartment of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York dDepartment of Internal Medicine, Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA eDepartment of Medicine, Division of Rheumatology, Faculty of Medicine Siriraj Hospital, Mahidol University fDepartment of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Veeravich
authors.initials: V
authors.lastname: Jaruvongvanich
authors.forename: Wasin
authors.initials: W
authors.lastname: Ahuja
authors.forename: Karn
authors.initials: K
authors.lastname: Wijarnpreecha
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
mesh_terms: D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D064887:Observational Studies as Topic; D016017:Odds Ratio; D011379:Prognosis; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid