The Correlation Between Serum Uric Acid and Metabolic Dysfunction-Associated Fatty Liver Disease: An Updated Systematic Review and Meta-Analysis.

Abstract

Objective: Recent epidemiological evidence suggests that serum uric acid (SUA) levels are believed to be strongly associated with the onset and development of metabolic dysfunction-associated fatty liver disease (MAFLD). Although existing meta-analyses have explored the relationship between the two, new research data continue to emerge, and it is necessary to conduct updated meta-analyses to provide more comprehensive evidence.

Methods: From the inception of the database until March 2025, we performed an extensive search for pertinent observational studies within the PubMed, Embase, and Web of Science databases. To evaluate the association between SUA levels and MAFLD, random effects models were employed to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Publication bias was assessed using Egger's test.

Results: In total, 61 studies were analyzed, encompassing 2,151,925 participants. MAFLD prevalence in individuals with hyperuricemia was 59% (between 50 and 69%), with an incidence rate of 28% (between 17 and 47%). Participants exhibiting elevated SUA levels demonstrated a pooled OR of 1.90(95%CI:1.77-2.04) for MAFLD in comparison to those with lower SUA levels. Subgroup analyses further revealed a consistent positive association between SUA levels and MAFLD across various categories, including study design, study quality, sample size, publication year, and geographic location.

Conclusion: This meta-analysis further confirmed the positive correlation between high SUA levels and the risk of MAFLD, suggesting that SUA may be a potential biomarker and therapeutic target for MAFLD.

Registration number: PROSPERO-CRD42024568760.