Gout and risk of non-alcoholic fatty liver disease

Objectives: To investigate the association between gout and non-alcoholic fatty liver disease (NAFLD).Methods: The study subjects were participants in a health-screening programme at Chang Gung Memorial Hospital from 2000 to 2006. Subjects were classified into eight groups based on serum urate (SU) level and gout status (≤ 4.9, 5.0–6.9, 7.0–8.9, and ≥ 9.0 mg/dL, without and with gout). The association between gout and NAFLD was assessed by multiple logistic regression.Results: Among a total of 54 325 subjects, 1930 (3.6%) had gout and 6169 (11.3%) had NAFLD. The prevalence of NAFLD was significantly higher in subjects with gout (23.1%, n = 445) than in those without gout (10.9%, n = 5724, p < 0.001). Among subjects with NAFLD, the severity of NAFLD was higher in gout patients. Gout was associated with an increased risk for NAFLD [odds ratio (OR) 1.42, 95% confidence interval (CI) 1.25–1.60, p < 0.001], after adjustment for age, sex, presence of metabolic syndrome, and low estimated glomerular filtration rate (eGFR). With SU ≤ 4.9 mg/dL in the absence of gout as reference, the ORs (95% CI) for NAFLD, after adjustment for age, sex, presence of metabolic syndrome, and low eGFR, were, respectively, 2.16 (1.94–2.41), 3.98 (3.55–4.46), and 5.99 (5.19–6.90) for SU levels 2–4 in those without gout and 2.61 (1.39–4.91), 2.87 (2.04–4.04), 4.53 (3.70–5.56), and 6.31 (5.12–7.77) for SU levels 1–4 in those with gout.Conclusions: There was an independent association between gout and the risk for NAFLD. In addition, there was a dose–response relationship between SU and NAFLD in subjects with and without gout.