Could serum uric acid levels be a biomarker for metabolic dysfunction-associated steatotic liver disease?

In this study, we investigated the relationship between serum uric acid (SUA) and metabolic dysfunction-associated steatotic liver disease (MASLD) in patients detected through abdominal ultrasound. The second aim was to determine if there were any gender differences.

High SUA levels may contribute to the mechanisms underlying various metabolic disorders, including MASLD.

We conducted a retrospective study among patients older than 18 who had been admitted to a tertiary hospital's gastroenterology outpatient clinic for over two years. A total of 200 patients diagnosed with either Grade 1, 2, or 3 hepatosteatosis by ultrasound screening and 200 patients without hepatosteatosis were included in the study. Patients' demographic features, laboratory parameters, and detailed medical history were extracted from the hospital's medical records.

The mean age of the 400 patients enrolled in the study was 47.92±0.78 years, and 70.25% were men. SUA (5.34 mg/dL ± 1.52 vs. 4.64 mg/dL ± 1.28, p=0.001), alanine aminotransferase (ALT) (26.55 U/L ± 23.82 vs. 19.57 U/L ± 20.81, p=0.002), aspartate aminotransferase (AST) (22.68 U/L ± 20.35 vs. 18.07 U/L ± 9.89, p=0.005), and glycosylated hemoglobin (HbA1c) (6.45% ± 1.69 vs. 5.76% ± 1.23, p=0.001) levels were higher in the MASLD group. In the MASLD group, HbA1c, AST, and ALT were significantly higher in the Grade 2-3 group than in the Grade 1 (p=0.038, p=0.038, p=0.001, respectively).

Elevated SUA levels are strongly linked to MASLD, particularly in males. Ease of measurement and low cost suggest that SUA could serve as a non-invasive biomarker for MASLD detection in at-risk groups.