Serum uric acid and non-alcoholic fatty liver disease in non-diabetic Chinese men

PLoS One. 2013 Jul 23;8(7):e67152. doi: 10.1371/journal.pone.0067152. Print 2013.


Increased serum uric acid (SUA) levels may be involved in the development of non-alcoholic fatty liver disease (NAFLD) in men presenting with metabolic syndrome (MetS) and/or insulin resistance. We aimed to determine the independent relationship between SUA and NAFLD in non-diabetic Chinese male population, and to explore the determinants of SUA levels among indexes of adiposity, lipid, and genotypes pertaining to triglycerides metabolism, inflammation, oxidative stress, and SUA concentrations. A total of 1440 men, classified depending on the presence of ultrasonographically detected NAFLD, underwent a complete healthy checkup program. Genotypes were extracted from our previously established genome-wide association study database. After adjusting for age, smoking, drinking, body mass index, homeostasis model assessment of insulin resistance, C-reactive protein, creatinine, alanine aminotransferase (ALT) and components of metabolic syndrome, the odds ratio for NAFLD, comparing the highest with the lowest SUA quartile, was 2.81 (95% confidence interval 1.66-4.76). A stepwise multivariate linear regression analysis (R(2) = 0.238, P<0.001) retained age, waist circumference, serum creatinine, triglycerides, the Q141K variant in ABCG2 (rs2231142) and NAFLD as significant predictors of SUA levels (all P<0.001). Besides, ALT and Met196Arg variant in TNFRSF1B (rs1061622) additionally associated with SUA among individuls with NAFLD. Our data suggest that in Chinese men, elevated SUA is significantly associated with NAFLD, independent of insulin resistance and other metabolic disorders, such as central obesity or hypertriglyceridemia. Meanwhile, among subjects with NAFLD, index of liver damage, such as elevated ALT combined with genetic susceptibility to inflammation associated with increased SUA levels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Asians*
  • China
  • Confidence Intervals
  • Diabetes Mellitus / blood
  • Fatty Liver / blood*
  • Fatty Liver / complications
  • Humans
  • Linear Models
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / complications
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease
  • Odds Ratio
  • Uric Acid / blood*
  • Young Adult


  • Uric Acid

Grant support

The work described in this article was supported by grants from the National Natural Science Foundation of China (81060029, 81060234, 30945204, 81060214), Key Program and University Talents Highland Innovation Team of Guangxi (2012012D003, GJR201147-09), Chairman Science and Technology Fund and Tackle Program of Guangxi (1116-03, GKG1298003-07-01), Guangxi Provincial Department of Finance and Education (2009GJCJ150), and Guangxi Natural Science Foundation (2011GXNSFA018175, and 2010GXNSFA013133). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.