Higher levels of serum uric acid influences hepatic damage in patients with non-alcoholic fatty liver disease (NAFLD)

• Conrado M. Fernández Rodríguez ^[1] ; Rocío Aller ^[7] ; María Luisa Gutiérrez García ^[1] ; Javier Ampuero ^[2] ; Judith Gómez-Camarero ^[8] ; Rosa M.ª Martín-Mateos ^[3] ; Diego Burgos-Santamaría ^[3] ; José Miguel Rosales ^[9] ; Patricia Aspichueta ^[4] ; Xabier Buque ^[4] ; Mercedes Latorre ^[10] ; Raúl J. Andrade ^[5] ; Manuel Hernández-Guerra ^[11] ; Manuel Romero-Gómez ^[6]
  1. [1] Fundación Hospital Alcorcón

     Fundación Hospital Alcorcón

     Alcorcón, España

     
  2. [2] Hospital Universitario Virgen del Rocío

     Hospital Universitario Virgen del Rocío

     Sevilla, España

     
  3. [3] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  4. [4] Universidad del País Vasco/Euskal Herriko Unibertsitatea

     Universidad del País Vasco/Euskal Herriko Unibertsitatea

     Leioa, España

     
  5. [5] Hospital Universitario Virgen de la Victoria

     Hospital Universitario Virgen de la Victoria

     Málaga, España

     
  6. [6] Universidad de Sevilla

     Universidad de Sevilla

     Sevilla, España

     
  7. [7] Hospital Clinic. Valladolid, Spain
  8. [8] Hospital Universitario. Burgos, Spain
  9. [9] Agencia Sanitaria Costa del Sol. Marbella, Málaga. Spain
  10. [10] Hospital General Universitario Consortium. Valencia, Spain
  11. [11] Hospital Universitario de Tenerife. Canary Islands, Spain

  Mostrar afiliaciones +
• Localización: Revista Española de Enfermedades Digestivas, ISSN-e 2340-4167, ISSN 1130-0108, Vol. 111, Nº. 4, 2019, págs. 264-269
• Idioma: inglés
• Enlaces
  • Texto completo
• Resumen

  • Background: recent evidence suggests a causal link between serum uric acid and the metabolic syndrome, diabetes mellitus, arterial hypertension, and renal and cardiac disease. Uric acid is an endogenous danger signal and activator of the inflammasome, and has been independently associated with an increased risk of cirrhosis. Aim and methods: six hundred and thirty-four patients from the nation-wide HEPAMET registry with biopsy-proven NAFLD (53% NASH) were analyzed to determine whether hyperuricemia is related with advanced liver damage in patients with non-alcoholic fatty liver disease (NAFLD). Patients were divided into three groups according to the tertile levels of serum uric acid and gender. Results: the cohort was composed of 50% females, with a mean age of 49 years (range 19-80). Patients in the top third of serum uric acid levels were older (p = 0.017); they had a higher body mass index (p < 0.01), arterial blood pressure (p = 0.05), triglyceridemia (p = 0.012), serum creatinine (p < 0.001) and total cholesterol (p = 0.016) and lower HDL-cholesterol (p = 0.004). According to the univariate analysis, the variables associated with patients in the top third were more advanced steatosis (p = 0.02), liver fibrosis (F2-F4 vs F0-1; p = 0.011), NASH (p = 0.002) and NAS score (p = 0.05). According to the multivariate logistic regression analysis, the top third of uric acid level was independently associated with steatosis (adjusted hazard ratio 1.7; CI 95%: 1.05-2.8) and NASH (adjusted hazard ratio 1.8; CI 95%: 1.08-3.0) but not with advanced fibrosis (F2-F4) (adjusted hazard ratio 1.09; CI 95%: 0.63-1.87). Conclusion: higher levels of serum uric acid were independently associated with hepatocellular steatosis and NASH in a cohort of patients with NAFLD. Serum uric acid levels warrants further evaluation as a component of the current non-invasive NAFLD scores of histopathological damage