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. 2022 Aug;36(8):e24590.
doi: 10.1002/jcla.24590. Epub 2022 Jul 8.

Serum uric acid to creatinine ratio is associated with higher prevalence of NAFLD detected by FibroScan in the United States

Rusha Wang  1 , Feiben Xue  1 , Liping Wang  1 , Guangxia Shi  1 , Guoqing Qian  1 , Naibin Yang  1 , Xueqin Chen  2
Affiliations

Serum uric acid to creatinine ratio is associated with higher prevalence of NAFLD detected by FibroScan in the United States

Rusha Wang et al. J Clin Lab Anal. 2022 Aug.

Abstract

Background: The association between the serum uric acid (sUA) to creatinine ratio (sUA/Cr) and non-alcoholic fatty liver disease (NAFLD) has not been sufficiently clarified. In this study, we investigated the relationship between sUA/Cr and NAFLD among participants in the United States.

Methods: We performed a cross-sectional study based on data from the National Health and Nutrition examination Survey (NHANES) 2017-2018. A measured controlled attenuation parameter (CAP) value of ≥274 dB/m detected by Fibroscan was used to identify hepatic steatosis. SUA/Cr was calculated as sUA divided by serum creatinine. Multivariate logistic regression analysis was used to estimate the association between sUA/Cr and NAFLD. The adjusted odds ratio (OR) of sUA/Cr for NAFLD was estimated, and subgroup analysis stratified by sex was also conducted. The nonlinear relationship between sUA/Cr and NAFLD was further described using smooth curve fittings and threshold-effect analysis.

Results: We found that sUA/Cr was positively correlated with NAFLD status after fully adjustment for confounding factors. In subgroup analysis stratified by sex, the positive interaction between sUA/Cr and NAFLD status only existed in women but not in men. Moreover, the nonlinear association between sUA/Cr and NAFLD status was an inverted U-shaped curve with an inflection point at 9.7 among men.

Conclusions: Our study identified that sUA/Cr was positively associated with the risk of NAFLD among individuals in the United States. Moreover, the correlation between sUA/Cr and NAFLD differed according to sex.

Keywords: NAFLD; NHANES; inflammation; serum uric acid to creatinine ratio; steatosis.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Flowchart of subjects included in this study
FIGURE 2
FIGURE 2
Associations between serum uric acid to creatinine ratio and CAP values or prevalence of NAFLD. (A) and (C): Each black point represents a sample. (B) and (D): Solid redline represents the smooth curve fit between variables. Blue bands represent the 95% of confidence interval from the fit. Adjusted for: sex, age, race, BMI, diabetes status, SBP, DBP, ALT, AST, GGT, glycohemoglobin, HDL‐cholesterol, total cholesterol, triglyceride, and serum albumin
FIGURE 3
FIGURE 3
Association between sUA/Cr and prevalence of NAFLD stratified by sex. Adjusted for: age, race, BMI, diabetes status, SBP, DBP, ALT, AST, GGT, glycohemoglobin, HDL‐cholesterol, total cholesterol, triglyceride, and serum albumin
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