血尿酸与非酒精性脂肪肝的相关性研究进展

doi:10.3969/j.issn.1007-9572.2018.00.232

中国全科医学 ›› 2018, Vol. 21 ›› Issue (27): 3397-3402.DOI: 10.3969/j.issn.1007-9572.2018.00.232

所属专题：消化系统疾病最新文章合辑

血尿酸与非酒精性脂肪肝的相关性研究进展

王丽莹，李强*

150086黑龙江省哈尔滨市，哈尔滨医科大学附属第二医院内分泌代谢病科
*通信作者：李强，教授，主任医师； E-mail：QiangLi26@126.com

出版日期:2018-09-20 发布日期:2018-09-20
基金资助:
基金项目：黑龙江省科技攻关课题（GAO7C303107）

Recent Advances in the Correlation between Serum Uric Acid and Nonalcoholic Fatty Liver Disease

WANG Li-ying，LI Qiang*

Department of Endocrinology and Metabolism，the 2nd Affiliated Hospital of Harbin Medical University，Harbin 150086，China
*Corresponding author：LI Qiang，Professor，Chief physician；E-mail：QiangLi26@126.com

Published:2018-09-20 Online:2018-09-20

摘要/Abstract

摘要： 近年来非酒精性脂肪肝（NAFLD）已经成为全球性慢性肝脏疾病常见的原因。随着研究的深入，人们对NAFLD的认识不再局限于肝脏本身，而是把其作为代谢综合征（MS）在肝脏的主要表现，与心血管疾病（CVD）、慢性肾脏疾病（CKD）等代谢性疾病密切相关，甚至可以作为全身性疾病的预测信号。越来越多的证据表明，血尿酸（SUA）的增加可以引起全身性代谢紊乱，包括MS、NAFLD等。本文结合SUA病理生理作用与NAFLD流行病学特点、机制等，综述了SUA与NAFLD的相关性，为NAFLD的早期发现、有效管理与监测提供理论支持。

关键词: 脂肪肝, 尿酸, 综述

Abstract: In recent years，nonalcoholic fatty liver disease（NAFLD）has been found to be a common cause of chronic liver disease all over the world.With the development of medical studies，NAFLD is no longer considered as a disorder only involves the liver，but main manifestations of the liver secondary to metabolic syndrome（MS）.NAFLD is closely associated with cardiovascular disease，chronic kidney disease and other metabolic diseases，and even can be used as a predictor for systemic disease.Increasing evidence show that elevated serum uric acid（SUA）may play a role in the development of MS，NAFLD and other systemic metabolic disorders.We reviewed the correlations between SUA and NAFLD based on analyzing the pathophysiology of SUA and epidemiological characteristics and mechanisms of NAFLD，with a view to providing theoretical support for early detection，effective management and monitoring of NAFLD.

Key words: Fatty liver, Uric acid, Review

王丽莹,李强. 血尿酸与非酒精性脂肪肝的相关性研究进展[J]. 中国全科医学, 2018, 21(27): 3397-3402. DOI: 10.3969/j.issn.1007-9572.2018.00.232.
WANG Li-ying,LI Qiang. Recent Advances in the Correlation between Serum Uric Acid and Nonalcoholic Fatty Liver Disease[J]. Chinese General Practice, 2018, 21(27): 3397-3402. DOI: 10.3969/j.issn.1007-9572.2018.00.232.

参考文献

［1］BROWNING J D，SZCZEPANIAK L S，DOBBINS R，et al.Prevalence of hepatic steatosis in an urban population in the United States：impact of ethnicity［J］.Hepatology，2004，40（6）：1387-1395.DOI：10.1002/hep.20466.3400
［2］VERNON G，BARANOVA A，YOUNOSSI Z M.Systematic review：the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults［J］.Aliment Pharmacol Ther，2011，34（3）：274-285.DOI：10.1111/j.1365-2036.2011.04724.x.3400
［3］CLEMENTE M G，MANDATO C，POETA M，et al.Pediatric non-alcoholic fatty liver disease：recent solutions，unresolved issues，and future research directions［J］.World J Gastroenterol，2016，22（36）：8078-8093.DOI：10.3748/wjg.v22.i36.8078.3401
［4］LU Z Y，SHAO Z，LI Y L，et al.Prevalence of and risk factors for non-alcoholic fatty liver disease in a Chinese population：an 8-year follow-up study［J］.World J Gastroenterol，2016，22（13）：3663-3669.3401
［5］CHALASANI N，YOUNOSSI Z，LAVINE J E，et al.The diagnosis and management of non-alcoholic fatty liver disease：practice guideline by the American Gastroenterological Association，American Association for the Study of Liver Diseases，and American College of Gastroenterology［J］.Gastroenterology，2012，142（7）：1592-1609.DOI：10.1053/j.gastro.2012.04.001.3401
［6］WONG R J，CHEUNG R，AHMED A.Nonalcoholic steatohepatitis is the most rapidly growing indication for liver transplantation in patients with hepatocellular carcinoma in the U.S.［J］.Hepatology，2014，59（6）：2188-2195.DOI：10.1002/hep.26986.3401
［7］KUSHIYAMA A，NAKATSU Y，MATSUNAGA Y，et al.Role of uric acid metabolism-related inflammation in the pathogenesis of metabolic syndrome components such as atherosclerosis and nonalcoholic steatohepatitis［J］.Mediators Inflamm，2016，2016：8603164.DOI：10.1155/2016/8603164.3401
［8］SHARAF EL DIN UAA，SALEM M M，ABDULAZIM D O.Uric acid in the pathogenesis of metabolic，renal，and cardiovascular diseases：a review［J］.J Adv Res，2017，8（5）：537-548.DOI：10.1016/j.jare.2016.11.004.3401
［9］MAIUOLO J，OPPEDISANO F，GRATTERI S，et al.Regulation of uric acid metabolism and excretion［J］.Int J Cardiol，2016，213：8-14.DOI：10.1016/j.ijcard.2015.08.109.3401
［10］KAMOGAWA E，SUEISHI Y.A multiple free-radical scavenging（MULTIS）study on the antioxidant capacity of a neuroprotective drug，edaravone as compared with uric acid，glutathione，and trolox［J］.Bioorg Med Chem Lett，2014，24（5）：1376-1379.DOI：10.1016/j.bmcl.2014.01.045.3401
［11］ASHTARI F，BAHAR M，AGHAEI M，et al.Serum uric acid level in patients with relapsing-remitting multiple sclerosis［J］.J Clin Neurosci，2013，20（5）：676-678.DOI：10.1016/j.jocn.2012.05.054.3401
［12］SAUTIN Y Y，NAKAGAWA T，ZHARIKOV S，et al.Adverse effects of the classic antioxidant uric acid in adipocytes：NADPH oxidase-mediated oxidative/nitrosative stress［J］.Am J Physiol Cell Physiol，2007，293（2）：C584-596.DOI：10.1152/ajpcell.00600.2006.3401
［13］MARTYN K D，FREDERICK L M，VON LOEHNEYSEN K，et al.Functional analysis of Nox4 reveals unique characteristics compared to other NADPH oxidases［J］.Cell Signal，2006，18（1）：69-82.DOI：10.1016/j.cellsig.2005.03.023.3401
［14］张涛，迟雁青，杜春阳，等.尿酸对人肾小管上皮细胞氧化应激和TGF-β表达的影响［J］.免疫学杂志，2014，30（7）：585-589.DOI：10.13431/j.cnki.immunol.j.20140128.3401
ZHANG T，CHI Y Q，DU C Y，et al.Effects of uric acid on oxidative stress and TGF-β expression of human renal tubular epithelia cell［J］.Immunological Journal，2014，30（7）：585-589.DOI：10.13431/j.cnki.immunol.j.20140128.3401
［15］LIU C Q，HE C M，CHEN N，et al.Serum uric acid is independently and linearly associated with risk of nonalcoholic fatty liver disease in obese Chinese adults［J］.Sci Rep，2016，6：38605.DOI：10.1038/srep38605.3401
［16］LIN H，LI Q，LIU X，et al.Liver fat content is associated with elevated serum uric acid in the Chinese middle-aged and elderly populations：Shanghai Changfeng Study［J］.PLoS One，2015，10（10）：e0140379.DOI：10.1371/journal.pone.0140379.3401
［17］LIU Z，QUE S，ZHOU L，et al.Dose-response relationship of serum uric acid with metabolic syndrome and non-alcoholic fatty liver disease incidence：a meta-analysis of prospective studies［J］.Sci Rep，2015，5：14325.DOI：10.1038/srep14325.3401
［18］YU T Y，JEE J H，BAE J C，et al.Serum uric acid：a strong and independent predictor of metabolic syndrome after adjusting for body composition［J］.Metabolism，2016，65（4）：432-440.DOI：10.1016/j.metabol.2015.11.003.3401
［19］CAI W，SONG J M，ZHANG B，et al.The prevalence of nonalcoholic fatty liver disease and relationship with serum uric acid level in Uyghur population［J］.Scientific World Journal，2014，2014：393628.DOI：10.1155/2014/393628.3401
［20］HUANG Q，YU J，ZHANG X，et al.Association of the serum uric acid level with liver histology in biopsy-proven non-alcoholic fatty liver disease［J］.Biomed Rep，2016，5（2）：188-192.DOI：10.3892/br.2016.698.3401
［21］WU S J，ZHU G Q，YE B Z，et al.Association between sex-specific serum uric acid and non-alcoholic fatty liver disease in Chinese adults：a large population-based study［J］.Medicine（Baltimore），2015，94（17）：e802.DOI：10.1097/MD.0000000000000802.3401
［22］WAN X，XU C，LIN Y，et al.Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism［J］.J Hepatol，2016，64（4）：925-932.DOI：10.1016/j.jhep.2015.11.022.3401
［23］LOMBARDI R，PISANO G，FARGION S.Role of serum uric acid and ferritin in the development and progression of NAFLD［J］.Int J Mol Sci，2016，17（4）：548.DOI：10.3390/ijms17040548.3401
［24］LI C，HSIEH M C，CHANG S J.Metabolic syndrome，diabetes，and hyperuricemia［J］.Curr Opin Rheumatol，2013，25（2）：210-216.DOI：10.1097/BOR.0b013e32835d951e.3401
［25］VACCA M，ALLISON M，GRIFFIN J L，et al.Fatty acid and glucose sensors in hepatic lipid metabolism：implications in NAFLD［J］.Semin Liver Dis，2015，35（3）：250-261.DOI：10.1055/s-0035-1562945.3401
［26］ZHI L，YUZHANG Z，TIANLIANG H，et al.High uric acid induces insulin resistance in cardiomyocytes in vitro and in vivo［J］.PLoS One，2016，11（2）：e0147737.DOI：10.1371/journal.pone.0147737.3401
［40］GOPAL K，JOHNSON T C，GOPAL S，et al.Correlation between beta-lipoprotein levels and outcome of hepatitis C treatment［J］.Hepatology，2006，44（2）：335-340.DOI：10.1002/hep.21261.3402
［41］GIRELLI D，PASINO M，GOODNOUGH J B，et al.Reduced serum hepcidin levels in patients with chronic hepatitis C［J］.J Hepatol，2009，51（5）：845-852.DOI：10.1016/j.jhep.2009.06.027.3402
［42］GOPAL K，JOHNSON T C，GOPAL S，et al.Correlation between beta-lipoprotein levels and outcome of hepatitis C treatment［J］.Hepatology，2006，44（2）：335-340.DOI：10.1002/hep.21261.3402
［43］BODLAJ G，HUBMANN R，SALEH K，et al.Alkaline phosphatase predicts relapse in chronic hepatitis C patients with end-of-treatment response［J］.World J Gastroenterol，2010，16（19）：2407-2410.DOI：10.3748/wjg.v16.i19.2407.3402
［44］EZZIKOURI S，KIMURA K，SUNAGOZAKA H，et al.Serum DHCR24 auto-antibody as a new biomarker for progression of hepatitis C［J］.EBioMedicine，2015，2（6）：604-612.DOI：10.1016/j.ebiom.2015.04.007.3402
［45］SAITO M，YANO Y，HIRANO H，et al.Serum NX-DCP as a new noninvasive model to predict significant liver fibrosis in chronic hepatitis C［J］.Hepat Mon，2015，15（2）：e22978.DOI：10.5812/hepatmon.22978.3402
［27］AVULA N R，SHENOY D.Evaluation of association of hyperuricaemia with metabolic syndrome and insulin resistance［J］.J Clin Diagn Res，2016，10（12）：OC32-34.DOI：10.7860/JCDR/2016/22182.9113.3402
［28］TAKIR M，KOSTEK O，OZKOK A，et al.Lowering uric acid with allopurinol improves insulin resistance and systemic inflammation in asymptomatic hyperuricemia［J］.J Investig Med，2015，63（8）：924-929.DOI：10.1097/JIM.0000000000000242.3402
［29］LANASPA M A，SANCHEZ-LOZADA L G，CHOI Y J，et al.Uric acid induces hepatic steatosis by generation of mitochondrial oxidative stress：potential role in fructose-dependent and -independent fatty liver［J］.J Biol Chem，2012，287（48）：40732-40744.DOI：10.1074/jbc.M112.399899.3402
［30］CHOI Y J，SHIN H S，CHOI H S，et al.Uric acid induces fat accumulation via generation of endoplasmic reticulum stress and SREBP-1c activation in hepatocytes［J］.Lab Invest，2014，94（10）：1114-1125.DOI：10.1038/labinvest.2014.98.3402
［31］SOZEN E，OZER N K.Impact of high cholesterol and endoplasmic reticulum stress on metabolic diseases：an updated mini-review［J］.Redox Biol，2017，12：456-461.DOI：10.1016/j.redox.2017.02.025.3402
［32］DE TORRE-MINGUELA C，MESA DEL CASTILLO P，PELEGRN P.The NLRP3 and pyrin inflammasomes：implications in the pathophysiology of autoinflammatory diseases［J］.Front Immunol，2017，8：43.DOI：10.3389/fimmu.2017.00043.3402
［33］CAI C，ZHU X，LI P，et al.NLRP3 deletion inhibits the non-alcoholic steatohepatitis development and inflammation in kupffer cells induced by palmitic acid［J］.Inflammation，2017，40（6）：1875-1883.DOI：10.1007/s10753-017-0628-z.3402
［34］WAN X，XU C，LIN Y，et al.Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism［J］.J Hepatol，2016，64（4）：925-932.DOI：10.1016/j.jhep.2015.11.022.3402
［35］RONCAL-JIMENEZ C A，LANASPA M A，RIVARD C J，et al.Sucrose induces fatty liver and pancreatic inflammation in male breeder rats independent of excess energy intake［J］.Metabolism，2011，60（9）：1259-1270.DOI：10.1016/j.metabol.2011.01.008.3402
［36］JOHNSON R J，NAKAGAWA T，SANCHEZ-LOZADA L G，et al.Sugar，uric acid，and the etiology of diabetes and obesity［J］.Diabetes，2013，62（10）：3307-3315.DOI：10.2337/db12-1814.3402
［37］ISHIMOTO T，LANASPA M A，LE M T，et al.Opposing effects of fructokinase C and A isoforms on fructose-induced metabolic syndrome in mice［J］.Proc Natl Acad Sci U S A，2012，109（11）：4320-4325.DOI：10.1073/pnas.1119908109.3402
［38］LANASPA M A，SANCHEZ-LOZADA L G，CICERCHI C，et al.Uric acid stimulates fructokinase and accelerates fructose metabolism in the development of fatty liver［J］.PLoS One，2012，7（10）：e47948.DOI：10.1371/journal.pone.0047948.3402
［39］旷历琼，王娜.中老年非酒精性脂肪肝患者临床特点及其与血脂、血尿酸水平的相关性分析［J］.疑难病杂志，2014，13（10）：1012-1014.DOI：10.3969/j.issn.1671-6450.2014.10.08.3402
KUANG L Q，WANG N.The characters of nonalcoholic fatty liver disease and the related risk factors with blood lipid and serum uric acid［J］.Chinese Journal of Difficult and Complicated Cases，2014，13（10）：1012-1014.DOI：10.3969/j.issn.1671-6450.2014.10.08.3402
［40］高锦凤，宋镇，何方平，等.非酒精性脂肪性肝病与尿酸水平和肾功能损伤的相关性研究［J］.疑难病杂志，2010，9（7）：518-520.DOI：10.3969/j.issn.1671-6450.2010.07.018.3402
GAO J F，SONG Z，HE F P，et al.Relationship between uric acid level and renal function impairment in nonalcoholic fatty liver disease［J］.Chinese Journal of Difficult and Complicated Cases，2010，9
（7）：518-520.DOI：10.3969/j.issn.1671-6450.2010.07.018.3402

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血尿酸与非酒精性脂肪肝的相关性研究进展

Recent Advances in the Correlation between Serum Uric Acid and Nonalcoholic Fatty Liver Disease

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