The relationship between serum uric acid, the degree of fatty li̇ver disease, metabolic risk factors and the consumption of beverages with fructose in non alcoholic fatty liver disease

ABSTRACT THE RELATIONSHIP BETWEEN SERUM URIC ACID, THE DEGREE OF FATTY LİVER DISEASE, METABOLIC RISK FACTORS AND THE CONSUMPTION OF BEVERAGES WITH FRUCTOSE IN NON ALCOHOLIC FATTY LIVER DISEASE Nowadays, nonalcoholic fatty liver disease (NAFLD) which is defined as hepatic component of the metabolic syndrome consisting of hyperlipidemia, glucose intolerance, obesity and hypertension covers a wide spectrum of liver damage from simple fatty liver to nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis. In our study, the relationship between serum uric acid levels which is identified as a significant risk factor for NAFLD in recent years, the degree of fatty liver assessed ultrasonographically, risk factors of metabolic syndrome and consumption of beverages with fructose was researched. By evaluating ultrasonografic liver elastography values of all patients with NAFLD that included in the study, we examined the relationship between influencing factors with the increase in the degree of hepatosteatosis. Randomly selected 100 patients, eligible for study, with NAFLD detected ultrasonographically and with varying degrees of hepatosteatosis were examined. We divided the NAFLD patients into two subgroups as Grade I with mild hepatosteatosis and Grade II with moderate hepatosteatosis. Seventy petients (%70) were in Grade I group and 30 patients (%30) were graded as Grade II. It was observed that with increasing grade, the number of metabolic syndrome components also increase in a compatible manner. Moreover, in our study, a significant positive correlation was found between the weekly consumption of beverages containing fructose and the average levels of serum uric acid (SUA) (p<0.001, r²=0.379). When the relationship between consumption groups of beverages containing fructose and levels of SUA were examined, average levels of SUA in consumption groups which are F1 (n=40), F2 (n=49) and F3 (n=11) were found 4.6±0.86 mg/dL, 5.7±1.2 mg/dL and 6.63±1.3 mg/dl respectively. It was observed that when patients' weekly consumption of beverages with fructose increased, levels of SUA increased as well, though those were within normal limits. Our work suggests that the increased levels of SUA observed in individuals with NAFLD can give an idea about the increase of liver stiffness (kPa). So, it can help to predict the prognosis of patients with NASH and cirrhosis. The directly proportional correlation between the elasto m/sn values and the increase in portal vein diameter (PVD) was found statistically significant (p = 0.02, r² = 0.22) .This correlation is significant in terms of showing fibrosis which is important on the phase of early portal hypertension and liver cirrhosis. In our study, it was found that increase in the grade of NAFLD is correlated with both PVD and the linear measurement of liver long axis. However, it was thought to be the early signs of portal hypertension. In many studies, it was revealed that survival time of patients and liver fibrosis progression which may occur in patients with chronic liver disease can be predicted by using sonographic liver elastography. Key words: Nonalcoholic fatty liver disease (NAFLD), serum uric acid level, fructose consumption, metabolic syndrome risk factors.