Hyperuricemia as therapeutic target in the metabolic dysfunction-associated steatotic liver disease

Hyperuricemia, defined as an increase in the level of blood uric acid over 360 μmol/L, is currently attracting the attention of researchers due to its high prevalence and potentially adverse effects on the development and progression of major chronic non-communicable diseases. According to epidemiological data, the prevalence of asymptomatic hyperuricemia in the European population reaches 21%, and 4% for gout. Objective. To systematize the published data on the effect of hyperuricemia on the progression of steatosis and fibrosis of the liver in patients with metabolic dysfunction-associated steatotic liver disease. Materials and methods. The PubMed, Medline, and eLibrary.ru databases were searched for papers published between 2004 and 2024 using the following keywords: «hyperuricemia», «gout», «uric acid», «fatty liver disease», «steatotic liver disease», «steatohepatitis», «fatty liver degeneration», «metabolic syndrome», and «obesity». Results. According to observational studies and meta-analyses, in patients with hyperuricemia, the odds ratio for the development of hepatic steatosis is 1.74—2.97, and 1.47—2.98 for hepatic fibrosis. Conclusion. The published data supporting the pathogenetic association between hyperuricemia and metabolic dysfunction-associated steatotic liver disease indicate the need to correct uric acid levels using non-drug measures and urate-lowering pharmacotherapy in patients with metabolic dysfunction-associated steatotic liver disease.