Relationship between normal serum uric acid levels and nonalcoholic fatty liver disease among Chinese people with normal body mass index

Objective Serum uric acid (SUA) levels have been identified to be associated with nonalcoholic fatty liver disease (NAFLD) which is often closely linked to obesity. However, few studies have examined the relationship between SUA levels and NAFLD in normal body mass index (BMI) people in whom NAFLD is noted not uncommon. We conducted this study to assess the association of SUA with NAFLD in Chinese normal-BMI people. Methods A total of 2 193 normal-BMI people (1 106 men and 1087 women) who participated in a health check-up were enrolled in this cross-sectional study. NAFLD was defined as a hepatic steatosis examined by liver ultrasonography in the absence of a second cause. Multiple regression analysis was performed to examine the relationship between SUA and NAFLD. Results Compared with people without NAFLD, those with NAFLD had significantly higher level of serum uric acid [males, (339.0±47.6) μmol/L vs.(309.3±53.5) μmol/L, t=3.296, P<0.01; female,(273.6±41.6) μmol/L vs. (243.9±47.6) μmol/L, t=3.178, P<0.01]. Multiple regression analysis revealed that the quartile 3 and 4 of SUA in both sexes had a higher (P<0.05) odds ratio for the presence of NAFLD than the lowest quartile [males, odds ratio:2.508 (1.255-3.374) and 3.383 (2.058-5.490) ; females, odds ratio:2.186 (1.090-4.384) and 2.420 (1.214-4.821),respectively],after adjusting for age, body mass index, blood urea nitrogen, serum creatinine, the liver-function test, metabolic components, high sensitivity C-reactive protein, and smoking status. Conclusions Increased SUA level, even within the normal range, are independently associated with the presence of NAFLD among normal-BMI people. Key words: Nonalcoholic fatty liver disease; Hepatic steatosis; Uric acid; Body mass index