Abstract: Objective The aim of this study to investigate serum uric acid (UA) levels and its clinical implications in patients with diabetes mellitus type 2 (T2DM) and concomitant metabolism-related fatty liver diseases (MAFLD). Methods A total of 514 patients with T2DM were admitted to the Department of Endocrinology and Metabolism in our hospital between 2012 and 2019, and out of them, 347 (67.5%) had concomitant MAFLD. The Logistic regression analysis was performed to analyze the risk factors for MAFLD, and the ROC curve was established to predict the performance of UA for MAFLD. Results The incidence of hyperuricemia (HUA) in our patients with T2DM was 8.2%, and the incidence of HUA in MAFLD group was 10.7%, significantly higher than 4.2% in non-MAFLD group (P<0.05); the incidence of dyslipidemia was 55.6%, significantly higher than 41.3% in non-MAFLD group (P<0.05) and the incidence of abnormal liver function tests was 45.2%, significantly higher than 31.7% in non-MAFLD group (P<0.05); the body mass index (BMI) in MAFLD group was (25.9±3.8) kg/m², significantly higher than that in non-MAFILD group [(23.9±3.1)kg/m², P<0.05]; serum alanine aminotransferase, aspartate transaminase and glutamyl transpeptidase levels in MAFLD group were 29(19,43)U/L, 18(13,25)U/L and 39(25,64)U/L, significantly higher than [21(15, 32)U/L, 15(12,20)U/L and 31(20,51)U/L, respectively, P<0.05] in non-MAFLD group; serum UA, fasting C-peptide and insulin resistance index in MAFLD group were (294.3±91.3)μmol/L, (1.9±1.0)ng/mL and 3.6 (2.9, 4.4), significantly higher than [(254.9±79.2)μmol/L, (1.6±0.8)ng/mL and 3.2(2.7,4.0), P<0.05] in non-MAFLD group; srum total cholesterol, triglyceride and high-density lipoprotein cholesterol levels in MAFLD group were (5.0±1.2) mmol/L, 2.3(1.7,3.5)mmol/L and (1.0±0.2) mmol/L, significantly different from [(4.7±1.2) mmol/L, 1.8(1.4±2.9)mmol/L and (1.1±0.4)mmol/L, respectively, P<0.05] in non-MAFLD group; the Logistic regression analysis showed that UA (OR=1.004, 95%CI: 1.001-1.006, P=0.005) was an independent risk factor for MAFLD, the ROC curve analysis showed that the area under the curve for UA to predict the occurrence of MAFLD in T2DM patients was 0.634, and when UA equal to 267.35μmol/L as the cut-off value, the diagnostic sensitivity and specificity for MAFLD were 56.8% and 66.5%, respectively. Conclusion In naïve patients with T2DM, the concomitant MAFLD, dyslipidemia, HUA and liver function impairment are common, and UA is an independent risk factor for MAFLD. The findings in our study suggest that we should not only pay attention to obesity and dyslipidemia, it is also necessary to monitor and control UA levels.

Key words: Metabolic-related fatty liver diseases, Type 2 diabetes, Blood uric acid