Correlation between the changing trajectories of serum uric acid and new onset nonalcoholic fatty liver disease / 中华健康管理学杂志

ABSTRACT

Objective:To explore the correlation between changing trajectories of serum uric acid and the onset of nonalcoholic fatty liver disease (NAFLD).Methods:A longitudinal cohort study. Total of 3 353 subjects who had routine health examination every year from January 2017 to December 2019 in the Health Management Center of the Second Affiliated Hospital of Dalian Medical University and met the inclusion criteria were selected as the research subjects. Four different serum uric acid trajectory groups were determined by using the group-based trajectory model the low stability group, medium stability group, medium-high stability group and high stability group. During the follow-up to December 2021, the differences in cumulative incidence of NAFLD in different serum uric acid trajectory groups were calculated and compared. Cox proportional hazard regression model was used to evaluate the hazard ratio ( HR) and 95% confidence interval ( CI) of the NAFLD onset in different serum uric acid trajectory groups. The dose-response relationship between baseline serum uric acid and NAFLD was evaluated by a restricted cubic spline regression model. Results:The cumulative incidence of NAFLD in two years was 10.77%, and the cumulative incidence increased with the rising trajectory of serum uric acid, it was the highestin the high stability group ( P<0.05). Compared that in the low stability group, the risk of NAFLD in the other three groups was as follows 2.24 (95% CI 1.59-3.14) in the medium stability group, 2.89 (95% CI 1.92-4.33) in the medium-high stability group and 4.55 (95% CI2.83-7.31) in the high stability group (all P<0.05). The risk of NAFLD gradually increased with the rising of serum uric acid level, and the cut-off value of serum uric acid for women and men was 260.32 μmol/L and 365.09 μmol/L, respectively. Conclusions:Long-term moderate and high levels of serum uric acid are independent risk factors for the occurrence of NAFLD. With the rising of serum uric acid trajectory, the risk of NAFLD increases. Attention should be paid to the longitudinal change trend of serum uric acid level in the prevention of NAFLD, and it should be controlled within lower level of the normal range.