# Association between uric acid and non-alcoholic fatty liver disease in patients with hypertension

**Authors:** Yan Zhao, Zhenwei Wang, Yang Liu, Ting Yang, Zhuang Li, Ao Gao, Lei Cao, Chongyang Ma, Aleksandra Klisic, Aleksandra Klisic, Aleksandra Klisic

PMC · DOI: 10.1371/journal.pone.0341949 · 2026-01-29

## TL;DR

High uric acid levels are linked to non-alcoholic fatty liver disease in people with hypertension, especially in certain groups like males and obese individuals.

## Contribution

This study identifies uric acid as a significant and independent risk factor for NAFLD in hypertensive patients.

## Key findings

- Uric acid levels were independently associated with NAFLD in hypertensive patients.
- Specific subgroups, such as males and obese individuals, showed a stronger link between uric acid and NAFLD.
- Adding uric acid to a baseline model slightly improved the prediction of NAFLD occurrence.

## Abstract

Serum uric acid (UA) is linked to non-alcoholic fatty liver disease (NAFLD), but its role in hypertensive populations remains unclear. This cross-sectional study investigated their association in 1,058 patients with hypertension. Multivariate logistic regression analysis confirmed that UA was independently correlated with NAFLD, whether as a continuous variable or a categorical variable. According to the fully adjusted model, the risk of NAFLD increased by 0.2%, 347.2% and 91.7% for each unit increase in UA, Log10UA and LnUA, respectively (P < 0.05). Multivariate stratified analysis revealed that UA increased the risk of NAFLD in specific subgroups, including males, individuals aged 70–79 years, non-smokers, those without diabetes, and obese individuals (P < 0.05). Receiver operating characteristic (ROC) analysis indicated that UA could not only predict the occurrence of NAFLD but also improve the predictive value of the baseline model for NAFLD (UA, AUC: 0.588; baseline model, AUC: 0.770; baseline model + UA, AUC: 0.772). In conclusion, UA is significantly associated with NAFLD in patients with hypertension and may serve as a predictive risk indicator.

## Linked entities

- **Chemicals:** uric acid (PubChem CID 1175)
- **Diseases:** non-alcoholic fatty liver disease (MONDO:0013209), diabetes (MONDO:0005015)

## Full-text entities

- **Genes:** IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, aspartate aminotransferase [NCBI Gene 107763872], NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, IRS1 (insulin receptor substrate 1) [NCBI Gene 3667] {aka HIRS-1}
- **Diseases:** obese (MESH:D009765), hyperuricemia (MESH:D033461), hyperinsulinemia (MESH:D006946), stroke (MESH:D020521), renal insufficiency (MESH:D051437), lipotoxic liver injury (MESH:D017093), hypertension (MESH:D006973), cancer (MESH:D009369), hepatocellular carcinoma (MESH:D006528), cirrhosis (MESH:D005355), IR (MESH:D007333), NAFLD (MESH:D065626), Diabetes (MESH:D003920), heart failure (MESH:D006333), liver disease (MESH:D008107), hepatocyte injury (MESH:D014947), overweight (MESH:D050177), cardiovascular and renal diseases (MESH:D002318), autoimmune and drug-induced liver disease (MESH:D056486), coronary artery disease (MESH:D003324), chronic kidney disease (MESH:D051436), dyslipidemia (MESH:D050171), hepatic steatosis (MESH:D005234), hepatic inflammation (MESH:D007249), metabolic disorder (MESH:D008659)
- **Chemicals:** lipid (MESH:D008055), glucose (MESH:D005947), PONE-D-25-57606R1 (-), free fatty acids (MESH:D005230), UA (MESH:D014527), reactive oxygen species (MESH:D017382), steroids (MESH:D013256), cholesterol (MESH:D002784), alcohol (MESH:D000438), TG (MESH:D014280)
- **Species:** hepatitis C virus [taxon 11103], Nicotiana tabacum (American tobacco, species) [taxon 4097], Homo sapiens (human, species) [taxon 9606], Hepatitis B virus (no rank) [taxon 10407]

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12854455/full.md

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Source: https://tomesphere.com/paper/PMC12854455