The Association Between Elevated Serum Uric Acid And Non-alcoholic Fatty Liver Disease:A Meta-analysis

Background and objective:Non-alcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases in China.It is a complex disease mediated by metabolism,environment,genetics and microorganisms.There is evidence that NAFLD is associated with elevated serum uric acid(SUA).The purpose of this study was to systematically assess the correlation between elevated SUA and NAFLD in Chinese population through a meta-analysis of existing evidence.Methods:PubMed,Embase and Cochrane libraries,cnki,wip and wanfang databases were used to search for literatures on elevated serum uric acid and non-alcoholic fatty liver disease in Chinese population published between the establishment of the library and November 2018.In addition,some literatures retrieved by hand were supplemented.Two researchers independently participated in the screening of literatures,evaluation of qualified literatures and data extraction.Stata12.0 and RevMan5.2 were used to analyze the combined effect.The odds ratios(OR)of each study were combined using a stochastic effect model.Subgroup analysis and sensitivity analysis were also performed in this meta-analysis to further test the stability of the results.The publication bias was detected by Egger's linear regression and funnel plot.Results:A total of 25 studies from 24 references that met the inclusion criteria were included in this meta-analysis,involving a total of 229,685 participants.Combined with the results of various studies,elevated serum uric acid can increase the risk of non-alcoholic fatty liver disease in Chinese population,with a combined OR value of 1.94 and a 95% CI of 1.74-2.16(P<0.05).Sensitivity analysis indicated that the results were stable.Subgroup analyses of the type,sex,and region of the study design also showed significant correlations.Both Egger's linear regression test and funnel plot suggested that there was no publication bias in the risk of non-alcoholic fatty liver disease.Conclusion:Elevated serum uric acid would increase the risk of NAFLD,providing new ideas for the screening of NAFLD risk factors.However,the mechanism of uric acid causing NAFLD needs to be further studied.