Associations Between Serum Uric Acid And The Remission Of Non-alcoholic Fatty Liver Disease

Objective:To investigate theassociations between serum uric acid(SUA)and the remission of Nonalcoholic fatty liver disease(NAFLD)in Chinese males in order to provide epidemiological evidence for prevention and control of NAFLD.Subjects and Methods:In the presentstudy,841 NAFLD males(30±75 years)were recruited from a Chinese prospective cohortstudy(PMMJS)and followed up for five years.Data on demographic characteristics,life styles,status of physical activity and history of diseases were obtained by trained investigators.Standardized methods were used to measure height,weight,blood pressure,waist circumference,hip circumference and BMI = weight/ height2 and others.Fasting blood was collected to measure fast plasma glucose(FPG),Triglyceride(TG),Total cholesterol(TC),High density lipoprotein(HDL),Low density lipoprotein(LDL),Alanine aminotransferase(ALT)and Aspartate aminotransferase(AST).The database was established and checked by Epidata3.0 software.All statistical analyses were conducted using SAS 9.4 software.The baseline SUA levels of participants werecategorized into four quartiles: 191μmol/L≤SUA≤347μmol,347μmol/L<SUA≤392μmol/L,392μmol/L<SUA≤441μmol/L and 441μmol/L<SUA≤676μmol/L.Multivariate analyses using logistic regression were performed to elucidate the relationship between the association between SUA level and the remission of NAFLD.All tests were two-sided and differences were considered statistically significant if P values were <0.05.Results:1.A total of 841 NAFLD males were included in the current study.The average age and SUA level of them were53.51±7.71 years old and 395.25±72.85μmol/L.Among them,108 individuals were remitted with the prevalence was 12.84%.The rate of smokers,hypertension,metabolic Syndrome and diabetes were 47.32%、31.15%、17.83% and 9.63%.2.ALT、AST、serum creatinine、TG、BMI and WC increased with SUA level while HDL decreased with SUA level,the difference were statistically significant.3.Incontrast to the participants with sustained NAFLD,the participants with remitted NAFLDwere relatively lower BMI(P = 0.0039)and WC(P = 0.0006),as well as lower serum levels ofAST(P = 0.0011),ALT(P <0.0001)and TG(P = 0.0293).4.By logistic regression model,the RR(95% CI)for remitted NAFLD comparing Q1 to 3 vs Q4 were 3.28(1.72-6.22),2.70(1.41-5.21),and 1.47(0.72-3.00)in unadjusted logistic models,respectively.The significant association was not affected after adjusting for additional variables,the RRQ1 vs Q4 was 3.16.5.Compared to the prevalence of NAFLD remission in the highest quartile of SUA(Q4),the presence of the lowest quartile of SUA levels(Q1)was significantly associated with remitted NAFLD even when the study population was stratified according to the median values of age,ALT,AST,serum creatinine and HDL.Moreover,low SUA level was significantly associated with remission of NALFDs wherein BMI> 26 kg/m2,AST≤23.0 U/L,TC≤4.8 mmol/L,TG≤1.9 mmol/L,LDL-C>3.0 mmol/L,non-smokers,drinkers,non-hypertension,non-Mets,no control of hypertension,no control of Mets,non-hypertension and non-MetS.6.In order to avoid the effects of anti-hypertension,anti-diabetes and anti-hyperlipidemia medicine on the NAFLD remission in the present study,we performed the sensitivity analysis to further evaluate the potential links between the SUA levels and NAFLD remission.In the unadjusted and multivariate model,the RR Q1 vs Q4 were 4.39(95%CI:1.92-10.02)and 3.07(95%CI:1.26-7.48).Conclusions:Our study found that the individuals with remitted NAFLD had a lower level of SUA and there was a significant association of NAFLD remission with decreased SUA level.This study suggested that SUA level plays a very important role in the progress of NAFLD and provided a new insight into the NAFLD prevention.