Serum uric acid as a biomarker for metabolic dysfunction-associated steatotic liver disease: insights from ultrasound elastography in a Chinese cohort

Abstract

Background: To evaluate the association between serum uric acid (SUA) levels and metabolic dysfunction-associated steatotic liver disease (MASLD), defined as excessive fat accumulation in the liver accompanied by at least one cardiometabolic risk factor, reflecting metabolic abnormalities associated with the condition, in a Chinese adult population. Methods: This study included 3829 participants aged ≥ 18 years who underwent abdominal transient elastography and had complete SUA data. SUA was categorized into low, medium, and high tertiles. Hepatic steatosis was defined as a controlled attenuation parameter (CAP) ≥ 248 dB/m. MASLD diagnosis followed the latest definitions by relevant liver disease associations. Logistic regression analyzed the association between SUA and MASLD. Restricted cubic spline regression assessed non-linear relationships. Results: A total of 1737 participants were diagnosed with MASLD. SUA levels were higher in the MASLD group (5.79 ± 1.50 mg/dL) than in the non-MASLD group (5.03 ± 1.35 mg/dL). SUA was linearly related to MASLD (P for nonlinearity = 0.8451). Both medium and high SUA groups had increased MASLD risk compared to the low SUA group (P < 0.05). Each unit increase in SUA was associated with a 14% higher risk of MASLD (odds ratio [OR] = 1.14, P = 0.0004). Conclusions: This study highlights the association between SUA levels and MASLD, suggesting that SUA may serve as a potential biomarker for MASLD risk assessment. Monitoring SUA levels could inform preventive strategies and facilitate early intervention, contributing to improved MASLD management.