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Association between the hyperuricemia and nonalcoholic fatty liver disease risk in a Chinese population: A retrospective cohort study.

ABSTRACT: Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease associated with high levels of serum uric acid (SUA). However, whether this relationship applies in obese subjects has been unclear, and no cohort study has previously been conducted in non-obese subjects. We therefore performed a retrospective cohort study among employees of seven companies in China to investigate whether hyperuricemia was independently associated with NAFLD in obese and non-obese subjects, respectively. A total of 2383 initially NAFLD-free subjects were followed up for four years, and 15.2% (363/2383) developed NAFLD. Hyperuricemia subjects had a higher cumulative incidence than did those with normouricemia (29.0% vs. 12.9%, P<0.001). Cox proportional hazard regression analyses showed that baseline hyperuricemia was significantly associated with risk of developing NAFLD in non-obese subjects. This relationship was significantly independent of baseline age, gender, metabolic syndrome components, and other clinical variables (RR = 1.389, 95%CI: 1.051-2.099). However, this association did not exist in obese subjects (RR = 1.010, 95%CI: 0.649-1.571). The independent effect of hyperuricemia on NAFLD was stronger in females (RR = 2.138, 95%CI: 1.050-4.355) than in males (RR = 1.435, 95%CI: 1.021-2.018). In conclusion, further studies are needed to explore the different mechanisms between obese and non-obese subjects, and the reason hyperuricemia raises NAFLD risk in females more than in males.

SUBMITTER: Yang C

PROVIDER: S-EPMC5433681 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Association between the hyperuricemia and nonalcoholic fatty liver disease risk in a Chinese population: A retrospective cohort study.

Yang Chao C Yang Shujuan S Xu Weiwei W Zhang Junhui J Fu Wenguang W Feng Chunhong C

PloS one 20170516 5

Nonalcoholic fatty liver disease (NAFLD) is a common chronic disease associated with high levels of serum uric acid (SUA). However, whether this relationship applies in obese subjects has been unclear, and no cohort study has previously been conducted in non-obese subjects. We therefore performed a retrospective cohort study among employees of seven companies in China to investigate whether hyperuricemia was independently associated with NAFLD in obese and non-obese subjects, respectively. A tot ...[more]

PMID: 28510581

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Project description:BackgroundSerum bilirubin may play a role in preventing antioxidant and cytoprotective effects in physiological conditions. Serum bilirubin levels are inversely correlated with insulin resistance and the prevalence of cardiovascular diseases and diabetes mellitus. However, the correlation between serum bilirubin and nonalcoholic fatty liver disease (NAFLD) is unclear. NAFLD in non-obese participants may lead to serious health problems, calling for prompt recognition and early management. This study aimed at investigating the relationship between the serum bilirubin levels and NAFLD in non-obese Chinese adults.MethodsWe evaluated 4,900 non-obese subjects (body mass index <25 kg/m2) residing in Wuwei, China. The subjects received a baseline questionnaire, physical examination, abdominal ultrasonography, and laboratory check-ups. Fasting serum bilirubin was measured with an automated biochemical analyzer. NAFLD was diagnosed based on imaging findings of fatty liver disease on ultrasonography, without excessive alcohol intake and other known causes for chronic liver disease. A logistic regression model was applied to calculate the association between serum bilirubin level and NAFLD in non-obese subjects.ResultsNAFLD was diagnosed in 408 (203 men) of the subjects, and they had a mean age of 51-year-old. Non-obese NAFLD patients had lower serum direct bilirubin (DBIL) levels than control group did [2.50 (1.80-3.25) vs. 2.60 (1.90-3.50), P=0.004], but no significant differences in indirect bilirubin (IBIL) and total bilirubin (TBIL) levels of the two groups was seen (both P>0.05). After adjusting confounding factors such as age, gender, body mass index, blood glucose, and blood lipids, multivariate analysis showed serum DBIL (OR: 0.96, 95% CI: 0.83-1.11, P trend =0.6022), IBIL (OR: 1.02, 95% CI: 0.89-1.17, P trend =0.7756), and TBIL (OR: 1.00, 95% CI: 0.87-1.15, P trend =0.991) levels were not associated with NAFLD in the non-obese population. In addition, subgroup analyses (stratified according to age, gender, and medical histories of hypertension, and diabetes mellitus) suggested no independent association between NAFLD and DBIL, IBIL, or TBIL.ConclusionsOur data suggest that serum bilirubin levels are unlikely to be associated with NAFLD in non-obese subjects.

Project description:BACKGROUND:Fasting plasma glucose (FPG) is an easily quantifiable and inexpensive metabolic marker, which is often used to assess cardiovascular disease and diabetes. However, there have been limited studies on the association between FPG and nonalcoholic fatty liver disease (NAFLD) risk in nonobese people, especially in Chinese individuals. The purpose of this study was to investigate the association between FPG and NAFLD in nonobese Chinese people with normal blood lipid levels. METHODS:In this prospective cohort study, 9767 nonobese participants with normal blood lipid levels without NAFLD were recruited and prospectively followed for 5 years. The Cox proportional hazard model was used to evaluate the risk factors of NAFLD. Moreover, a Cox model with cubic spline functions and smooth curve fitting (the cubic spline smoothing) were used to identify the nonlinear association between FPG and NAFLD. RESULTS:During the 5-year follow-up, 841 (8.61%) participants were diagnosed with NAFLD. The good functional results (without NAFLD) estimated by the Kaplan-Meier method for 1 year, 2 years, 3 years, 4 years, and 5 years were 98.84, 95.35, 91.67%, 87.57 and 74.86%, respectively. Additionally, through the Cox proportional hazard model, after adjusting for other covariates, there was an independent positive correlation between FPG and increased NAFLD risk (HR:1.21, 95% CI:1.15-1.28, P?<?0.0001), and the NAFLD risk was incrementally higher with the rising FPG quartile. The nonlinear association between FPG and NAFLD was visualized by cubic spline smoothing technique. It was calculated that the inflection point of FPG was 5.54. When FPG???5.54, there was a positive correlation between FPG and the risk of NAFLD (HR:2.20, 95% CI:1.78-2.73, P?<?0.0001). When FPG?>?5.54, the risk of NAFLD increased by 50% (HR:1.10, 95% CI:1.02-1.18, P?=?0.0159) compared with the left side of the inflection point and gradually leveled off. CONCLUSIONS:In a nonobese Chinese population with normal lipid levels, there is an independent nonlinear association between FPG and NAFLD, and the increase in FPG may indicate an increased risk of NAFLD. Additionally, this independent association is more obvious in the short stature population.

Project description:PurposeSerum uric acid (UA) not only affects the development of obesity but also alters the metabolic status in obese subjects; thus we investigated the relationship between serum UA and the overweight/obese metabolic phenotypes.MethodsThe demographic, biochemical, and hematological data were collected for 12,876 patients undergoing routine physical examination, and 6,912 participants were enrolled in our study. Participants were classified into four obesity metabolic phenotypes according to their BMI and the presence of metabolic syndrome: metabolically healthy overweight/obese (MHOO), metabolically healthy and normal weighted (MHNW), metabolically abnormal and overweight/obese (MAOO), and metabolically abnormal but normal weighted (MANW). Univariate and multivariate logistic regression analysis, stratified analysis, and also interaction analysis were conducted to analyze the relationship between serum UA and obesity metabolic phenotypes.ResultsMultivariable logistic regression analysis showed that hyperuricemia was positively associated with MHOO, MANW, and MAOO phenotypes relative to MHNW. After adjusting for the confounding factors, the odds ratios (OR) for individuals with hyperuricemia to be MHOO, MANW, and MAOO phenotypes were 1.86 (1.42-2.45), 2.30 (1.44-3.66), and 3.15 (2.34-4.24), respectively. The ORs for having MHOO, MANW, and MAOO increased 6% [OR: 1.06 (1.05-1.07), P < 0.0001], 5% [OR: 1.05 (1.03-1.07), P < 0.0001], and 11% [OR: 1.11 (1.10-1.13), P < 0.0001] for each 10 unit (μmol/L) of increase in serum UA level. Stratification analysis as well as an interaction test showed that sex and age did not interfere with the association of hyperuricemia with each metabolic phenotype. In terms of the components of the metabolic syndrome, after adjusting for other confounding factors including all of the metabolic indicators except itself, hyperuricemia was positively associated with increased BMI [OR: 1.66 (1.32-2.09), P < 0.0001], hypertriglyceridemia [OR: 1.56 (1.21-2.02), P = 0.0006], and hypertension [OR: 1.22 (1.03-1.46), P = 0.0233], while it had no significant association with hyperglycemia and low HDL-C (all P > 0.05).ConclusionIn our study, we discovered that hyperuricemia was positively associated with MHOO, MANW, and MAOO phenotypes, and this relationship was independent of sex and age.

Dataset Information

Association between the hyperuricemia and nonalcoholic fatty liver disease risk in a Chinese population: A retrospective cohort study.

Publications

Association between the hyperuricemia and nonalcoholic fatty liver disease risk in a Chinese population: A retrospective cohort study.

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