| Summary: | Qianjia Sun,1,2,* Tingjing Zhang,3,* Laeeqa Manji,4 Yashu Liu,1,2 Qing Chang,1,2 Yuhong Zhao,1,2 Yang Ding,5,6 Yang Xia1,2 1Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, People’s Republic of China; 2Key Laboratory of Precision Medical Research on Major Chronic Disease, Shenyang, People’s Republic of China; 3School of Public Health, Wannan Medical College, Wuhu, People’s Republic of China; 4International Educational School, China Medical University, Shenyang, People’s Republic of China; 5Department of Infectious Diseases, Shengjing Hospital of China Medical University, China Medical University, Shenyang, People’s Republic of China; 6Diagnosis and Treatment Centre for Liver Diseases of Liaoning Province, Shenyang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yang Xia, Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, People’s Republic of China, Tel +86 24-96615-13650, Email xytmu507@126.com; yxia@cmu.edu.cn Yang Ding, Department of Infectious Diseases, Shengjing Hospital of China Medical University, No. 36, San Hao Street, Shenyang, Liaoning, 110004, People’s Republic of China, Tel +86 24-96615-62211, Email yding0903@sina.comObjective: Recent epidemiological evidence shows that there is an association between serum uric acid (SUA) levels and nonalcoholic fatty liver disease (NAFLD). The purpose of this meta-analysis is to summarize all available evidence and assess the associations between SUA levels and NAFLD.Methods: Using two databases, Web of Science and PubMed, observational studies were applied from the establishment of the databases to June 2022. We used a random effect model to construct the pooled odds ratio (OR) and 95% confidence interval (CI) to appraise the association between SUA levels and NAFLD. The Begg’s test was conducted to appraise publication bias.Results: A total of 50 studies were included, involving 2,079,710 participants (719,013 NAFLD patients). The prevalence and incidence rates (95% CIs) of NAFLD in the patients with hyperuricemia were 65% (57– 73%) and 31% (20– 41%), respectively. Compared to participants with lower levels of SUA, the pooled OR (95% CI) of NAFLD in those with higher levels of SUA was 1.88 (95% CI: 1.76– 2.00). In the subgroup analyses, we found that SUA levels were positively associated with NAFLD in all subgroups, according to study design, study quality, sample size, sex, comparison, age, or country.Conclusion: This meta-analysis shows that increased SUA levels are positively associated with NAFLD. The results suggested that reducing SUA levels can be a potential strategy for the prevention of NAFLD.Registration Number: PROSPERO-CRD42022358431.Keywords: serum uric acid, nonalcoholic fatty liver disease, meta-analysis, updated
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