The association of serum uric acid level and the uric acid to creatinine ratio with non alcoholic fatty liver disease in children with obesity

It has been demonstrated that elevated serum uric acid (sUA) levels elicit both pro-inflammatory and pro-oxidative effects. A growing body of evidence suggests that this may play a contributory role in the development of Non-alcoholic fatty liver disease (NAFLD) in children with obesity. The objective of the present study is to evaluate the association between sUA levels, the sUA/creatinine (Cr) ratio and paediatric NAFLD. This single-center, cross-sectional, comparative study was conducted at a tertiary care center. The study cohort comprised 228 patients with obesity (body mass index (BMI) ≥ 95th percentile) and 167 healthy controls without obesity or overweight. Both groups were 9-18 years of ages, matched for sex and pubertal stage. A diagnosis of NAFLD was made following an ultrasound examination of the liver, with other possible causes of hepatic disease being excluded. A significantly elevated level of sUA, and sUA/Cr values weres observed in the group of patients with obesity in comparison to the control group (p < 0.001). In the group with obesity, NAFLD was detected by abdominal ultrasonography in 169 (74.2%) patients, whereas NAFLD was not detected in 59 (25.8%) patients. The levels of sUA and sUA/Cr were significantly elevated in the obese NAFLD group in comparison to the obese non-NAFLD and control groups (p < 0.001). An elevated WC, ALT, and the ratio of sUA/Cr were associated with an increased risk of NAFLD. A one-unit increase in sUA/Cr was found to be associated with an increased risk of NAFLD (OR = 1.323, 95% CI: 1.001-1.748). The findings of our study indicate that an elevated WC, ALT, and the ratio of sUA/Cr were associated with an increased risk of NAFLD. Nevertheless, no such correlation was identified between sUA and NAFLD.