Uric acid versus metabolic syndrome as markers of fatty liver disease in young people with overweight/obesity

Diabetes Metab Res Rev. 2022 Oct;38(7):e3559. doi: 10.1002/dmrr.3559. Epub 2022 Jul 5.

Abstract

Aims: To compare the association of high serum uric acid (HUA) or metabolic syndrome (MetS) with fatty liver disease (FLD) in youths with overweight/obesity (OW/OB).

Materials and methods: Cross-sectional study of anthropometrics, biochemical variables, and liver ultrasound of 3104 individuals with OW/OB (age 5-17 years). Metabolic syndrome was defined by ≥ 3 criteria among (1) high waist circumference; (2) high triglycerides; (3) low high-density lipoproteins; (4) fasting glucose ≥100 mg/dl; (5) blood pressure ≥95th percentile in children, and ≥130/80 mmHg in adolescents. High serum uric acid was defined as serum UA value ≥ 75th percentile adjusted for sex. Fatty liver disease was determined by echography.

Results: The sample was stratified in four categories: (1) no HUA, no MetS (reference category); (2) MetS; (3) HUA; (4) HUA and MetS (HUA + MetS). The prevalence of FLD increased across the four categories from 29.9%, 44.0%, 52.2%, to 67.1%, respectively (p < 0.0001). The ORs for the categorical variables were 1.33 (1.06-1.68) for MetS (p = 0.02), 3.19 (2.51-4.05) for HUA (p < 0.0001) and 3.72 (2.65-5.21) for HUA + MetS (p < 0.0001), versus the reference category regardless of the body mass index.

Conclusions: HUA represents a useful marker of FLD in youths with OW/OB, given its greater ability to identify those at increased risk of the disease compared to MetS. The ability of both to predict incident FLD must be investigated in longitudinal study.

Keywords: children; fructose; metabolic syndrome score; non-alcoholic fatty liver disease; obesity; uric acid.

MeSH terms

  • Adolescent
  • Biomarkers
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Glucose
  • Humans
  • Lipoproteins, HDL
  • Liver Diseases*
  • Longitudinal Studies
  • Metabolic Syndrome*
  • Obesity / epidemiology
  • Overweight / complications
  • Prevalence
  • Risk Factors
  • Triglycerides
  • Uric Acid

Substances

  • Biomarkers
  • Lipoproteins, HDL
  • Triglycerides
  • Uric Acid
  • Glucose