Background And Study Aims: The question of whether elevated serum uric acid is an independent risk factor for nonalcoholic fatty liver disease evident on ultrasonography was investigated by longitudinal approach in Japanese undergoing a health checkup.

Patients And Methods: A total of 1,386 male and 3,453 female nondrinkers participating in health checkups in both 2000 and 2005 were included. Multiple logistic regression analyses were performed for 1,042 men (51.4 +/- 11.2 years old) and 3,076 women (51.8 +/- 9.2 years old) to identify independent factors for newly developed nonalcoholic fatty liver disease in 2005. Adjustment was made for age, body mass index, body mass index increase for 5 years, systolic blood pressure, triglyceridemia, fasting blood glucose, and smoking.

Results: The prevalence of nonalcoholic fatty liver disease and body mass index, systolic blood pressure, and triglyceride were significantly higher in the participants with elevated serum uric acid, with a significant increasing trend in relation to serum uric acid quartiles. Nonalcoholic fatty liver disease was newly diagnosed in 17.4% of males and 8.2% of females, respectively, in 2005. Serum uric acid adjusted for other factors was a risk factor for nonalcoholic fatty liver disease in both sexes and quartiles 3 and 4 had significantly elevated risks. The odds ratio and 95% confidence interval for one increment of serum uric acid were 1.31 and 1.11-1.56 in men and 1.30 and 1.10-1.53 in women, respectively.

Conclusions: Elevated serum uric acid is an independent risk factor for nonalcoholic fatty liver disease in Japanese undergoing a health checkup.

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