The association between the serum levels of uric acid and alanine aminotransferase in a population-based cohort

Background & Aims Elevated serum uric acid levels reflect and also cause both oxidative stress and insulin resistance and are frequently observed in patients with the metabolic syndrome. A strong association exists between the metabolic syndrome and non‐alcoholic fatty liver disease (NAFLD). Therefore, we aimed to test the association between uric acid and elevated alanine aminotransferase (ALT), as a surrogate for NAFLD, using real‐world data. Methods Data used for the cross‐sectional study were obtained from Maccabi Healthcare System, a 2‐million member health maintenance organization in Israel. The population consisted of individuals aged 20–60 years who underwent blood tests for ALT and uric acid between 1997 and 2012. Individuals with secondary liver disease, celiac, and inflammatory bowel‐disease were excluded. Subgroup analysis was performed in subjects who were given the diagnosis of fatty liver in their medical records (n = 2628). Results The study population included 82 608 people (32.5% men, mean age 43.91 ± 10.15 years). There was a significant positive dose‐response association between serum uric acid levels and the rate of elevated serum ALT (P for trend