The Association of Persistent Hyperuricemia With Liver Function and the Management of Uric Acid Levels: Insights From a Three-Year Prospective Cohort Study

Objective

The association of long-term hyperuricemia with liver function remains less well understood. This prospective cohort study aimed to investigate the relationship between hyperuricemia and liver function as well as other metabolic and cardiovascular parameters.

Methods

We enrolled 375 participants with hyperuricemia and 599 normouricemic controls. Participants were followed up for 3 years, and data on liver indicators, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver ultrasonography were collected. Additionally, we assessed other parameters, such as renal function, lipid profile, blood pressure, fasting blood-glucose (FBG), and body mass index (BMI).

Results

The highest prevalence of hyperuricemia was observed in the 20–29 age groups for the participants. Among the comorbidities of patients with hyperuricemia, the proportion of dyslipidemia is the highest (58.13%), followed by fatty liver (50.13%) and liver function impairment (33.07%). During the three-year follow-up period, compared to the baseline, patients with persistent hyperuricemia showed significant increases in BMI, triglycerides, total cholesterol, AST, and ALT levels (p < 0.05). Meanwhile, patients with improved hyperuricemia for 2 years exhibited significant decreases in FBG, total cholesterol, serum creatinine (p < 0.05), along with a significant increase in eGFR (p < 0.05). Correlation analysis revealed that levels of uric acid were positively correlated with ALT, FBG, and triglycerides in persistent hyperuricemia (p < 0.05).

Conclusion

Hyperuricemia shows a notable trend of younger age onset. Persistent hyperuricemia, correlated with elevated ALT levels, indicates an increasing risk of liver damage that should be concerned about. Effective management of hyperuricemia could improve metabolic disorders and renal dysfunction.