Determining the role for uric acid in non-alcoholic steatohepatitis development and the utility of urate metabolites in diagnosis: An opinion review

Abstract

There has long been a recognised association between non-alcoholic fatty liver disease (NAFLD) and the composite aspects of the metabolic syndrome. Part of this association highlighted the supposed co-existence of elevated uric acid levels in those with NAFLD. There is interest in exploitation of this as a putative diagnostic and prognostic biomarker in NAFLD. Given the increased economic and health burden associated with the NAFLD epidemic, improved methods of population-based, minimally-invasive methods and biomarkers are clearly highly sought and necessary. In this opinion review we review the proposed role of uric acid in the pathogenesis of NAFLD and its potential utilisation in the diagnosis and monitoring of the disease process.

Keywords: Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Uric acid; Urate; Non-invasive fibrosis markers; Fatty liver index

Core tip: There is significant interest in the role of uric acid as both a causative aetiological proponent in non-alcoholic fatty liver disease as well as its diagnostic utility in the diagnosis of fatty liver disease. Within this review we explore these putative molecular mechanisms which are likely implicated, in addition to exploring the most recent translational evidence of uric acid as a diagnostic tool in the clinical environ.