Serum uric acid trajectories and sex-specific risk of nonalcoholic fatty liver in China: A 2019–2021 cohort health survey

Abstract Objective To investigate the sex-specific associations between serum uric acid (UA) trajectories and the risk of nonalcoholic fatty liver disease (NAFLD) in large cohort survey 2019–2021. Methods This cohort health survey included 11644 participants without NAFLD before January 1, 2021; of them, 5578 (47.90%) were men and 6066 (52.10%) were women. The group-based trajectory model method was applied to identify serum UA trajectories from January 1, 2019, to December 30, 2021. New-onset NAFLD events in 2021 were treated as outcomes. A logistic regression model was used to assess sex-specific associations between UA trajectories and incidence of NAFLD. Results Four distinct serum UA trajectories among both sexes were identified: “low-stable” trajectory 1 (n = 783 men; n = 1143 women), “moderate–moderate increasing” trajectory 2 (n = 2794 men; n = 3266 women), “moderate high–moderate increasing” trajectory 3 (n = 1660 men; n = 1464 women), and “high-increasing” trajectory 4 (n = 341 men; n = 193 women). During the 3-year follow-up period, 840 (15.06%) men and 408 (6.72%) women developed NAFLD. Compared with the trajectory 1 group, the trajectory 4 group had the highest risk (odds ration [OR] 2.99 [95% confidence interval {CI} 1.70, 5.24] for men; OR 2.37 [95% CI 1.04, 5.33] for women), followed by the trajectory 3 (OR 2.23 [95% CI 1.52, 3.30] for men; OR 2.37 [95% CI 1.45, 3.92] for women) and trajectory 2 (OR 1.43 [95% CI 1.07, 1.94] for men; OR 1.37 [95% CI 0.93, 2.03] for women) groups. Conclusions High serum UA trajectories were independent risk factors for NAFLD in both sexes.