Serum Uric Acid/Creatinine Ratio as a Potential Biomarker for Non-alcoholic Fatty Liver Disease in Type 2 Diabetes

Abstract

Background: One of the predominant diseases among patients suffering from Type 2 diabetes mellitus (T2DM) is non-alcoholic fatty liver disease (NAFLD). Finding reliable biomarkers for predicting NAFLD severity is required for early intervention and prevention of further diseases such as fibrosis, hepatocellular cancer, and liver failure among these patients. The objective of our study was to find out that among T2DM patients can serum uric acid/creatinine ratio (SUA/CR ratio) predict NAFLD severity. Materials and Methods: The sample size of this cross-sectional study was 108 T2DM patients (56 males, 52 females). The participants are further divided into two groups NAFLD Grade 1 and NAFLD grade 2(Confirmed by Ultrasonography). We assessed biochemical parameters such as SUA, Creatinine, SUA/CR ratio (calculated), plasma fasting glucose (FBS), total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density cholesterol (HDL-C), glycated hemoglobin (HbA1c), Triglyceride (TG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). SUA/Cr ratio was calculated. Statistical analyses (t-tests, analysis of variance) were performed to identify predictors of NAFLD severity. Results: Grade 1NAFLD patients showed a decreased SUA/CR ratio than Grade 2 NAFLD patients with T2DM. Grade 2 NAFLD group was presented with increased SUA/CR, TGs, TC, and LDL levels and elevated ALT than Grade 1 NAFLD patients, indicating injury to the liver (P = 0.001). FBS, HbA1c, HDL-C cholesterol, and AST are not positively associated with SUA/CR ratio in Grade 1 and Grade 2 NAFLD groups. Conclusion: SUA/CR ratio is a simple and cost-effective marker linked with the severity of NAFLD, dyslipidemia, and elevated ALT among patients suffering with T2DM. SUA/CR might predict the risk of NAFLD and the severity of NAFLD among the T2DM population. In the future, large longitudinal studies should validate these findings.