Value of uric acid and uric acid/creatinine ratio in screening for metabolic dysfunction-associated fatty liver disease in young men

doi:10.3877/cma.j.issn.1674-0785.2024.12.006

Abstract

Abstract:

Objective

To explore the correlation of serum uric acid (SUA) and serum uric acid/creatinine (SUA/SCr) ratio with metabolic associated fatty liver disease (MAFLD) in young men, and to compare the value of the two in the preliminary screening of MAFLD.

Methods

Demographic data,laboratory results, and imaging data of young males from the physical examination population were collected.The research subjects were divided into Q₁～Q₄ groups and Q₁’～Q₄’ groups according to the quartiles of SUA and SUA/SCr ratio, respectively.

Results

A total of 419 subjects were included (147 in MAFLD group and 272 in non-MAFLD group). The MAFLD group had higher age (36 years vs 35 years, P＜0.01), body mass index (BMI; 27.05 vs 24.19, P＜0.001), systolic blood pressure (128.11 mmHg vs 121.26 mmHg,P＜0.001), diastolic blood pressure (77.13 mmHg vs 72.82 mmHg, P＜0.001), fasting blood glucose (5.36 mmol/L vs 5.15 mmol/L, P＜0.001), triglycerides (1.75 mmol/L vs 1.10 mmol/L, P＜0.001), and eGFR(115.44 ml/min vs 102.81 ml/min, P＜0.001) levels, but a lower high-density lipoprotein (1.39 mmol/L vs 1.54 mmol/L, P＜0.001) level than the non-MAFLD group. There were statistically significant differences in SUA and SUA/Scr between the two groups. In the Q₁～Q₄ group divided by SUA, the positive rate of MAFLD accounted for 12.9%, 25.2%, 25.9%, and 36.1% of all MAFLD cases, respectively (χ²=24.98, P＜0.001). In the Q₁’～Q₄’ group divided by SUA/SCr ratio, the positive rate of MAFLD was 12.9%, 22.4%, 29.9%, and 34.7%, respectively (χ²=25.60, P＜0.001). After adjusting for age, SBP, DBP, BMI, HDL-C, LDL-C, TG,FBG, etc., the risk of MAFLD in the Q₄ group was 2.28 times that of the Q₁ group (P=0.04), and the risk of MAFLD in the Q₄’ group was still 2.94 times that of the Q₁’ group (P=0.007). There was no significant difference in the area under the ROC curve between SUA (0.655) and SUA/SCr ratio (0.663) for screening for MAFLD.

Conclusion

SUA and SUA/SCr ratio are both risk factors for MAFLD. The screening value of SUA/SCr ratio for MAFLD is not superior to that of SUA in young men.

Key words: Metabolic dysfunction-associated fatty liver disease, Serum uric acid to serum creatinine ratio, Uric acid

Xiaowei Wei, Jing Xue, Weibo Zhao, Lintao Shi, Suying Xia, Jinyi Shi, Jing Wang, Haiying Jia, Aihong Wang. Value of uric acid and uric acid/creatinine ratio in screening for metabolic dysfunction-associated fatty liver disease in young men[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(12): 1111-1117.

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Figures/Tables 6

项目	MAFLD 组（n=147）	非MAFLD 组（n=272）	χ ²/t/Z 值	P 值
年龄[ 岁，M（Q₁，Q₃）]	36.0（33.0～41.0）	35.0（32.0～39.0）	-2.15	0.031
BMI[kg/m²， $\overset{ˉ}{x}$ ±s）]	27.05±2.89	24.19±2.27	11.16	＜0.001
SBP[mmHg，M（Q₁，Q₃）]	128.11±11.50	121.26±12.53	5.49	＜0.001
DBP[mmHg，M（Q₁，Q₃）]	77.13±9.26	72.82±9.44	4.49	＜0.001
FPG[mmol/L，M（Q₁，Q₃）]	5.36（5.15～5.72）	5.15（4.91～5.42）	-5.80	＜0.001
LDL-C[mmol/L，M（Q₁，Q₃）]	3.11（2.58～3.44）	3.00（2.45～3.35）	-1.49	0.137
HDL-C[mmol/L，M（Q₁，Q₃）]	1.39（1.24～1.5）	1.54（1.36～1.71）	6.51	＜0.001
TC[mmol/L，M（Q₁，Q₃）]	1.75（1.22～2.28）	1.10（0.80～1.47）	-8.70	＜0.001
Scr[μmol/L，M（Q₁，Q₃）]	95（87～100）	95（89～100）	0.52	0.60
eGFR[ml/min，M（Q₁，Q₃）]	115.44（105.12～127.87）	102.81（93.15～112.06）	-6.88	＜0.001
SUA（μmol/L， $\overset{ˉ}{x}$ ±s））	405.57±70.48	363.73±70.34	5.80	＜0.001
SUA/Scr[M（Q₁，Q₃）]	4.41（3.83～4.90）	3.86（3.35～4.49）	-5.51	＜0.001

项目	MAFLD 组（n=147）	非MAFLD 组（n=272）	χ ²/t/Z 值	P 值
年龄[ 岁，M（Q₁，Q₃）]	36.0（33.0～41.0）	35.0（32.0～39.0）	-2.15	0.031
BMI[kg/m²， $\overset{ˉ}{x}$ ±s）]	27.05±2.89	24.19±2.27	11.16	＜0.001
SBP[mmHg，M（Q₁，Q₃）]	128.11±11.50	121.26±12.53	5.49	＜0.001
DBP[mmHg，M（Q₁，Q₃）]	77.13±9.26	72.82±9.44	4.49	＜0.001
FPG[mmol/L，M（Q₁，Q₃）]	5.36（5.15～5.72）	5.15（4.91～5.42）	-5.80	＜0.001
LDL-C[mmol/L，M（Q₁，Q₃）]	3.11（2.58～3.44）	3.00（2.45～3.35）	-1.49	0.137
HDL-C[mmol/L，M（Q₁，Q₃）]	1.39（1.24～1.5）	1.54（1.36～1.71）	6.51	＜0.001
TC[mmol/L，M（Q₁，Q₃）]	1.75（1.22～2.28）	1.10（0.80～1.47）	-8.70	＜0.001
Scr[μmol/L，M（Q₁，Q₃）]	95（87～100）	95（89～100）	0.52	0.60
eGFR[ml/min，M（Q₁，Q₃）]	115.44（105.12～127.87）	102.81（93.15～112.06）	-6.88	＜0.001
SUA（μmol/L， $\overset{ˉ}{x}$ ±s））	405.57±70.48	363.73±70.34	5.80	＜0.001
SUA/Scr[M（Q₁，Q₃）]	4.41（3.83～4.90）	3.86（3.35～4.49）	-5.51	＜0.001

项目	Q ₁（n=105）	Q ₂（n=107）	Q ₃（n=103）	Q ₄（n=104）	χ ²/Z 值	P 值
年龄[ 岁，M（Q>₁，Q₃）]	35（32～39）	36（33～40）	36（33～40）	35（32.25～38.75）	-2.35	0.504
BMI（kg/m²，x±s）	24.03±2.55^d	24.76±2.46^d	25.82±2.70	26.19±3.16^a,b	13.75	＜0.001
SBP[mmHg，M（Q₁，Q₃）]	121.38±11.33^d	124.08±11.93^d	122.24±13.04	126.95±13.46^a,b	4.07	0.007
DBP[mmHg，M（Q₁，Q₃）]	72.93±9.12^d	73.67±9.10^d	74.03±9.20^d	76.76±10.59^a,b,c	3.19	0.024
FPG[mmol/L，M（Q₁，Q₃）]	5.26（4.89～5.48）	5.23（5.03～5.50）	5.23（4.96～5.56）	5.28（5.05～5.55）	2.26	0.520
LDL-C[mmol/L，M（Q₁，Q₃）]	2.87（2.35～3.275）	3.12（2.49～3.46）	3.11（2.63-3.36）	3.095（2.5825～3.3575）	5.83	0.120
HDL-C[mmol/L，M（Q₁，Q₃）]	1.49（1.305～1.69）	1.5（1.31～1.66）	1.47（1.33-1.65）	1.42（1.3～1.6375）	2.58	0.461
TG[mmol/L，M（Q₁，Q₃）]	1.03（0.825～1.365）^b,c,d	1.22（0.87～1.8）^a,d	1.24（0.88～1.8）^a,d	1.57（1.115～2.2475）^a,b,	29.67	＜0.001
Scr[μmol/L，M（Q₁，Q₃）]	93（86.2～98）	95（85～100）	95.6（89～100）	96.5（90.625～101）	7.03	0.071
eGFR[ml/min，M（Q₁，Q₃）]	103.63（92.05～111.31）	106.21（94.27～120.80）	107.46（96.92～118.60）^a	109.51（96.72～119.76）^a	10.25	0.017
MAFLD（N，%）	19（12.9）^b,c,d	37（25.2）^a,d	38（25.9）^a,d	53（36.1）^a,b,c	24.98	＜0.001

项目	Q ₁’（n=105）	Q ₂’（n=106）	Q ₃’（n=105）	Q ₄’（n=103）	χ ²/Z 值	P 值
年龄[ 岁，M（Q₁，Q₃）]	35（32～39）	37（33～40）	36（32～40）	35（32～39）	5.81	0.121
BMI[kg/m， $\overset{ˉ}{x}$ ±s]	24.18±2.46^c,d	24.93±2.74^d	25.60±2.69^a	26.06±3.17^a,b	13.75	＜0.001
SBP[mmHg，M（Q₁，Q₃）]	121.96±11.22^d	122.82±11.61^d	1223.29±12.51	126.66±14.52^a,b	2.80	0.04
DBP[mmHg，M（Q₁，Q₃）]	73.07±9.01	73.90±9.04	74.06±10.45	76.33±9.64	2.22	0.085
FPG[mmol/L，M（Q₁，Q₃）]	5.28（5～5.495）	5.2（4.9325～5.5125）	5.28（5.05～5.5375）	5.2（5.01～5.5）	1.70	0.637
LDL-C[mmol/L，M（Q₁，Q₃）]	2.9（2.35～3.35）	3.145（2.4975～3.4275）	3.1（2.65～3.36）	2.99（2.55～3.36）	3.19	0.363
HDL-C[mmol/L，M（Q₁，Q₃）]	1.52（1.29～1.705）	1.5（1.3675～1.6425）	1.49（1.315～1.615）	1.4（1.3～1.68）	5.29	0.152
TG[mmol/L，M（Q₁，Q₃）]	1.05（0.795～1.465）^d	1.2（0.875～1.74）^c,d	1.4（0.985～2.07）^a,b	1.33（1.03～2.08）^a,b	24.64	＜0.001
Scr[μmol/L，M（Q₁，Q₃）]	96（92.5～101）^c,d	98（90.75～102）^d	95（87.5～99.5）^a,d	90（77～96）^a,b,c	43.70	＜0.001
eGFR[ml/min，M（Q₁，Q₃）]	100.47（89.83～108.06）^b,c,d	104.29（94.32～115.27）^a,d	109.07（95.98～117.87）^a,d	119.72（107.17～140.54）^a,b,c	67.13	＜0.001
MAFLD（N，%）	19（12.9）^b,c,d	33（22.4）^a,d	44（29.9）^a	51（34.7）^a,b	25.60	＜0.001

项目	Q ₁’（n=105）	Q ₂’（n=106）	Q ₃’（n=105）	Q ₄’（n=103）	χ ²/Z 值	P 值
年龄[ 岁，M（Q₁，Q₃）]	35（32～39）	37（33～40）	36（32～40）	35（32～39）	5.81	0.121
BMI[kg/m， $\overset{ˉ}{x}$ ±s]	24.18±2.46^c,d	24.93±2.74^d	25.60±2.69^a	26.06±3.17^a,b	13.75	＜0.001
SBP[mmHg，M（Q₁，Q₃）]	121.96±11.22^d	122.82±11.61^d	1223.29±12.51	126.66±14.52^a,b	2.80	0.04
DBP[mmHg，M（Q₁，Q₃）]	73.07±9.01	73.90±9.04	74.06±10.45	76.33±9.64	2.22	0.085
FPG[mmol/L，M（Q₁，Q₃）]	5.28（5～5.495）	5.2（4.9325～5.5125）	5.28（5.05～5.5375）	5.2（5.01～5.5）	1.70	0.637
LDL-C[mmol/L，M（Q₁，Q₃）]	2.9（2.35～3.35）	3.145（2.4975～3.4275）	3.1（2.65～3.36）	2.99（2.55～3.36）	3.19	0.363
HDL-C[mmol/L，M（Q₁，Q₃）]	1.52（1.29～1.705）	1.5（1.3675～1.6425）	1.49（1.315～1.615）	1.4（1.3～1.68）	5.29	0.152
TG[mmol/L，M（Q₁，Q₃）]	1.05（0.795～1.465）^d	1.2（0.875～1.74）^c,d	1.4（0.985～2.07）^a,b	1.33（1.03～2.08）^a,b	24.64	＜0.001
Scr[μmol/L，M（Q₁，Q₃）]	96（92.5～101）^c,d	98（90.75～102）^d	95（87.5～99.5）^a,d	90（77～96）^a,b,c	43.70	＜0.001
eGFR[ml/min，M（Q₁，Q₃）]	100.47（89.83～108.06）^b,c,d	104.29（94.32～115.27）^a,d	109.07（95.98～117.87）^a,d	119.72（107.17～140.54）^a,b,c	67.13	＜0.001
MAFLD（N，%）	19（12.9）^b,c,d	33（22.4）^a,d	44（29.9）^a	51（34.7）^a,b	25.60	＜0.001

组别	模型1		模型2		模型3
组别	OR（95%CI）	P 值	OR（95%CI）	P 值	OR（95%CI）	P 值
Q ₁	1.0	-	1.0	-	1.0	-
Q ₂	1.78（1.02，3.10）	0.042	1.86（1.06，3.25）	0.030	1.46（0.74， 2.92）	0.278
Q ₃	1.97（1.13，3.42）	0.017	2.06（1.18，3.61）	0.011	1.16（0.58， 2.34）	0.677
Q ₄	4.70（2.51，8.82）	＜0.001	4.79（2.54，9.01）	＜0.001	2.28（1.04， 5.03）	0.040

组别	模型1		模型2		模型3
组别	OR（95%CI）	P 值	OR（95%CI）	P 值	OR（95%CI）	P 值
Q ₁	1.0	-	1.0	-	1.0	-
Q ₂	1.36（0.79，2.35）	0.271	1.43（0.89， 2.49）	0.206	1.37（0.69， 2.70）	0.368
Q ₃	2.17（1.23，3.81）	0.007	2.37（1.33，4.20）	0.003	1.57（0.78， 3.18）	0.208
Q ₄	4.44（2.37，8.33）	＜0.001	4.60（2.43，8.67）	＜0.001	2.94（1.35，6.41）	0.007

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