الفهرس 
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Abstract
Angulo (2002) defined hepatic steatosis as the buildup of fat, mostly triglycerides, inside the parenchyma of the liver. According to ultrasonography studies carried out in several nations, NAFLD affects 25% of the general population (Bellentani et al., 2010).
Dietary, metabolic, and genetic variables all have a role in NAFLD, claim Fan et al. According to Li et al. (2009) and Kuo et al. (2010), oxidative stress, insulin resistance, and systemic inflammation are also recognized as significant risk factors for the starting or progression of liver disorders, including NAFLD and NASH.
Numerous observational studies (Lee et al., 2010; Yamada et al., 2010) have shown that hyperuricemia is a risk factor for NAFLD in eastern Asian populations independent of the components of the metabolic syndrome (MetS). According to Wang et al. (2018) and Ali et al. (2020), high uric acid levels have been associated with endothelial dysfunction, insulin resistance, oxidative stress, and systemic inflammation. Each of these variables has an impact on how NAFLD develops (Petta et al., 2011). As a result, the change from non-NASH to NASH is brought on by elevated uric acid levels (Jaruvongvanich et al., 2017).
The goal of this research is to look at any potential connections between blood uric acid levels and the degree of liver damage in NAFLD.
It is cross-sectional in nature and observational. In addition to healthy controls, this research will include people with NAFLD who have received an ultrasonographic diagnosis. Between March 2022 and February 2023, they will be selected from among the patients who come to the outpatient clinics run by the Internal Medicine and Tropical Medicine departments at Minia University Hospital.
All patients and controls underwent a complete blood count, renal function tests (serum creatinine and blood urea), fasting blood glucose, antibodies to HCV, hepatitis B surface antigen, and HIV, as well as liver function tests (ALT, AST, total and direct bilirubin, serum albumin), serum uric acid, anti-nuclear antibodies, and lipid profile. An abdominal ultrasound was also used to evaluate the kind and severity of steatosis. The extent of fibrosis in the hepatic tissues was assessed by two-dimensional shear wave elastography (2D SWE).
We found that the mean anthropometric measures, such as BMI, hip circumference, and waist circumference, for the NAFLD group were substantially greater than those for the control group in this research (P value: 0.001). When we compared the NAFLD-positive patients (N = 70) with the NAFLD-negative patients (N = 70), this was verified.
There was no statistically significant difference between the NAFLD group and the healthy controls in terms of demographic information (age, sex, and place of residence; P values: 0.201, 0.192, and 0.839, respectively).
We discovered that the mean blood urea, mean blood creatinine, and mean liver enzyme levels of patients with NAFLD were substantially different from those of healthy controls (P values: 0.001, 0.005, and 0.011, respectively).
Higher blood triglyceride, LDL, and cholesterol levels were associated with dyslipidemia in the NAFLD group compared to the control group (P values: 0.001, 0.001, and 0.001, respectively).
Based on the ultrasonographic grading of liver steatosis, the majority of NAFLD patients [38 (54.3%)] had grade I steatosis, followed by those with grade II steatosis [21 (30%)] and those with grade III steatosis [11 (15.7%)]. Additionally, mean shear wave scanning evaluations of stiffness were considerably greater in NAFLD patients compared to controls. The METAVIR fibrosis score for the majority of NAFLD patients [40 (57.1%)] was F2, followed by patients with F0, F1, and F3 [12 (17.1%), 10 (14.3%), and 8 (11.5%), respectively.
In this investigation, we discovered that patients with NAFLD had considerably higher mean serum uric acid levels than healthy controls (P = 0.001). 39 (55%) of the NAFLD patients had hyperuricemia.
The degree of steatosis identified by abdominal ultrasonography, the degree of fibrosis detected by shear wave scanning, and the liver fibrosis scores of HSI, FIB4, NFS, and METAVIR have all been demonstrated to significantly correlate with blood uric level.
The incidence of NAFLD was also considerably greater in individuals with hyperuricemia than in those without. Between the first and fifth sex-specific quintiles, the prevalence of NAFLD was 53.6%, 20.7%, 30.8%, 19.4%, and 100%, respectively. An increased risk of developing NAFLD was linked to rising SUA levels.
With an AUC of 74%, sensitivity of 64%, and specificity of 94%, the blood uric acid level was statistically significant for the diagnosis of NAFLD at a cut-off value of 5.3 (P value: 0.001).
We discovered by univariate analysis that serum creatinine, uric acid, blood urea, and blood urea nitrogen substantially linked with NAFLD. A significant correlation between NAFLD and BMI, waist circumference, serum triglycerides, serum creatinine, and serum uric acid was found by multivariate logistic regression analysis.