Objective To investigate the association between liver fibrosis and serum uric acid in patients with type 2 diabetes mellitus( T2 DM) and nonalcoholic fatty liver disease( NAFLD). Methods A total of 328 patients with T2 DM and NAFLD who attended Cangzhou People's Hospital from January 2018 to August 2019 were enrolled,and according to NAFLD fibrosis score( NFS) and fibrosis-4( FIB-4)index,they were divided into low-risk fibrosis group with 136 patients,intermediate-risk fibrosis group with 145 patients,and high-risk fibrosis group with 47 patients. A total of 141 patients with T2 DM,matched for age and sex,were enrolled as T2 DM group. Serum uric acid was compared between groups. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between multiple groups,and the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used to determine the influencing factors for liver fibrosis,and the receiver operating characteristic( ROC) curve was used to evaluate the predictive efficiencies of risk factors. Results Compared with the T2 DM group,the T2 DM + NAFLD group had a significant increase in serum uric acid( 313. 04 ± 100. 90 vs 265. 00 ± 77. 01,t =-5. 619,P < 0. 001). The high-risk fibrosis group had a significant increase in serum uric acid compared with the low-risk fibrosis group( 392. 77 ± 108. 37 vs 290. 70 ± 95. 46,P < 0. 05) and the intermediate-risk fibrosis group( 392. 77 ± 108. 37 vs 328. 15 ± 90. 85,P < 0. 05),and the high-risk fibrosis group had a significantly higher prevalence rate of hyperuricemia than the low-risk fibrosis group and the intermediate-risk fibrosis group( 47. 00% vs 11. 72% vs 11. 76%,P < 0.01). The logistic regression analysis showed that serum uric acid( odds ratio = 1. 133,95% confidence interval: 1. 064-1. 312) was an independent risk factor for liver fibrosis in patients with T2 DM and NAFLD. The ROC curve showed that serum uric acid had a certain value in predicting liver fibrosis,with an area under the ROC curve of 0. 745. Conclusion The high level of serum uric acid is an independent risk factor for the development and progression of liver fibrosis in patients with T2 DM and NAFLD.
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