Association of Uric Acid to Creatinine Ratio with Metabolic Dysfunction-Associated Fatty Liver in Non-Obese Individuals Without Type 2 Diabetes Mellitus.

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease, which is usually associated with type 2 diabetes mellitus (TDM) and obesity. However, the incidence of MALFD in non-obese individuals without TDM is increasing, and the pathogenesis is unclear. Serum uric acid to creatinine ratio (sUA/Cr) can reflect overall metabolic status. This study aims to observe the association between sUA/Cr and MAFLD in non-obese individuals without TDM.

Methods: A total of 21,996 individuals were included in this study. The subjects were divided into four subgroups: non-obese patients without TDM, obese patients without TDM, non-obese patients with TDM, and obese patients with TDM. Logistic regression analyzed the correlation between sUA/Cr and MAFLD subgroups. Receiver operating characteristics analyzed the predictive value of sUA/Cr for MAFLD subgroups. The stratified analyses by sex and age were performed.

Results: Non-obese MAFLD individuals without TDM had higher sUA/Cr levels than their counterparts. sUA/Cr was significantly correlated positively with MAFLD in non-obese patients. Similar results were observed in both males and females and in populations at all age stages (all <0.01). sUA/Cr was capable of discriminating MAFLD in non-obese individuals without TDM (AUC: 0.667), especially for patients over 60 years old (AUC: 0.704).

Conclusion: The sUA/Cr ratio was correlated with MAFLD in non-obese patients without TDM. The predictive value of sUA/Cr for MAFLD was observed. Hence, the sUA/Cr ratio might be given more concern for the risk of MAFLD in non-obese individuals without TDM.