Abstract
Objective: To investigate the association between serum uric acid and the risk of new-onset nonalcoholic fatty liver disease(NAFLD). Methods: An observational cohort study was conducted in a hospital for five years. 856 patients without NAFLD who took physical examination in the hospital physical examination center in 2011 were selected as study subjects. According to the baseline level of serum uric acid, subjects were divided into 4 groups (F1, F2, F3, and F4). After 5-years of follow-up, the incidence of NAFLD in each group was observed in 2016.Serum alanine aminotransferase and aspartate aminotransferase, Total cholesterol, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, Triglycerides, Fasting blood glucose and Imaging findings were examined. The cumulative incidence rate of NAFLD in each group was compared and the effect of baseline serum uric acid level on new-onset NAFLD was analyzed by Logistic regression. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of uric acid level in NAFLD. Results: The cumulative incidence rate of NAFLD was 19.16%, and the cumulative incidence increased with the increase of baseline uric acid. The incidence rates of F1, F2, F3 and F4 were 7.90%, 13.54%, 20.32% and 34.07% respectively. The difference was statistically significant (P < 0.05). The incidence rate of NAFLD in F2, F3 and F4 groups were 1.637 (0.856 ~ 3.344) times, 2.745 (1.345 ~ 5.211) times and 5.465 (2.977 ~ 9.843) times higher than those in F1 group (P < 0.05). The logistic regression analysis showed that the risk of NAFLD increased with the increase of serum uric acid level, and the serum uric acid level was an independent risk factor for NAFLD with a relative risks (RR) value of 1.654. The ROC curve analysis of serum uric acid levels had no diagnostic value for NAFLD. Conclusion: Our study demonstrates that increased serum uric acid level is an independent risk factor for the development of NAFLD and could be used as an investigative indicator to assess the risk.