A Population Based Study of Liver Function amongst Adults with Hyperuricemia and Gout in the United States

Abstract

To examine the association between uric acid levels and liver enzyme functions amongst adults with hyperuricemia and gout in the United States. The National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2016 was used to study the research objective. Data were analyzed for descriptive statistics and for differences using the t test, Chi-square test and ANOVA. A regression analysis was performed to determine association between demographics and liver enzymes. A p value of <0.05 or <0.001 was considered statistically significant. A total of 14,946 adults (≥20 yrs.) were included in this study. Sample mean age was 49 ± 0.15 yrs., and 54% were female. Overall, 15% adults had elevated uric acid levels (≥6.8 mg/dL), men had significantly higher uric acid levels than women (6 mg/dL vs. 4.8 mg/dL). High uric acid levels were associated with more than two times higher odds of elevated ALT, AST and GGT (p < 0.001). Similarly, gender-based target uric acid values were associated with two-fold increased odds of GGT, over one-and-a-half fold higher odds of ALT and AST (p < 0.001). Regression analysis showed significant association between age, gender, race/ethnicity, body mass index, and hypertension and ALT, AST, ALP, total bilirubin and GGT (p < 0.001). Adults with hyperuricemia and gout are most likely to develop liver dysfunctions and suffer associated morbidities. Such patients need to be appropriately monitored and managed for their liver functions and to prevent associated morbidities.

Association between serum uric acid levels of patients with gout and their complications and examination fees: A cross‐sectional analysis

“…As indicated, high SUA levels are related to more than twice the levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase. 6,26,27 The results of the present study indicate that as SUA increased by 1 μmol/L, the influence of developing liver diseases increased by 1.003 times, which is consistent with previous studies. Overall, the results of this study further support the significance of SUA levels in standard treatment for gout.…”

“…10,11 In addition to the pain caused by gout itself, abnormal uric acid metabolism may also be closely related to numerous complications. [4][5][6] In a study comparing medical expenses and medical utilization between gout and non-gout patients, it was found that the average annual medical expenses of inpatients with gout were 2.9 times higher than those of outpatients with gout. 12 This is consistent with the present study.…”

“…2 It has been demonstrated that gout and hyperuricemia are related to various complications, such as hypertension, coronary heart disease, myocardial infarction, kidney diseases, and liver diseases. [4][5][6] Moreover, high SUA levels can cause significant economic losses to patients, including direct (eg medical consultation fees) and indirect (eg loss of productivity) costs. [7][8][9] However, there are relatively few published studies on the association between SUA levels in gout patients and examination fees and complications.…”

“…Elevated SUA concentration (hyperuricemia) is considered the most important influence factor for the development of gout 2 . It has been demonstrated that gout and hyperuricemia are related to various complications, such as hypertension, coronary heart disease, myocardial infarction, kidney diseases, and liver diseases 4–6 . Moreover, high SUA levels can cause significant economic losses to patients, including direct (eg medical consultation fees) and indirect (eg loss of productivity) costs 7–9 .…”

Rapid identification of early renal damage in asymptomatic hyperuricemia patients based on urine Raman spectroscopy and bioinformatics analysis

“…However, the process of uric acid excretion is complex as, after its filtration through the glomeruli, a series of reabsorption and re-secretion processes occur in the proximal renal tubules, the mechanisms of which are still not fully understood. Excessive concentrations of uric acid deposited in the kidneys and joints can not only lead to kidney stones and gout, but also cause cardiovascular diseases such as hypertension and atherosclerosis ( Deb and Sakharkar, 2021 ; Shin and Lee, 2021 ). Consequently, although uric acid was once considered to be simply an end product of purine metabolism with no physiological value, new knowledge has led to the understanding that it is actually a major endogenous water-soluble antioxidant whose antioxidant effects are similar to those of vitamin C ( Gong et al, 2022 ).…”