Linking Hyperuricemia to Disease Progression in Non-Alcoholic Fatty Liver Disease: Evidence from a Multi-Center Cohort
DOI:
https://doi.org/10.65761/jbs.v1.i1.4Keywords:
Hyperuricemia, Non-alcoholic fatty liver disease (NAFLD), Disease progression, Uric acid, Fibrosis, Multi-center cohortAbstract
Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver condition worldwide, with progression to non-alcoholic steatohepatitis (NASH), fibrosis, and cirrhosis leading to substantial morbidity. Emerging evidence suggests that hyperuricemia may play a contributory role in the progression of NAFLD, but robust multi-center cohort data are limited.
Objective: This study aimed to investigate the association between hyperuricemia and disease progression in NAFLD patients using data from a large, multi-center cohort.
Methods: One thousand two hundred and fifty-nine patients with NAFLD were recruited in five tertiary care centers and followed at a mean of 5 years. The level of serum uric acid was assessed at baseline. Progression of disease was classified as fibrosis progressive phase, acquisition of NASH or cirrhosis, which were determined by liver biopsies, imaging, and non-invasive biomarkers. Independent predictors of progression were determined using multivariate Cox proportional hazards models.
Results: In 37.6% of the cohort, there was hyperuricemia. The rates of disease progression were higher in patients with hyperuricemia as compared to patients with normal uric acid levels (34.8% vs. 19.5, p<0.001). Following the confounder, hyperuricemia was also an independent predictor of NAFLD progression (adjusted HR: 1.87; 95% CI: 1.45-2.41 p<0.001). Kaplan-Meier analysis showed that hyperuricemic patients experienced significantly remain progression.
Conclusion: Hyperuricemia is a strong and independent predictor of disease progression in patients with NAFLD. Monitoring serum uric acid levels could enhance risk stratification, and future interventional studies targeting uric acid metabolism may open new avenues for preventing NAFLD-related liver damage.
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