Uric acid as a potential marker of cardiometabolic risk in children and adolescents with metabolic dysfunction associated steatotic liver disease.

Aim of the study: The new term "metabolic dysfunction associated steatotic liver disease" (MASLD) focuses on the bidirectional interplay between fatty liver and metabolic dysregulation. The aim of this study was to evaluate serum concentrations of uric acid (UA) in overweight/obese children and adolescents and to determine the association of this parameter with MASLD and metabolic dysregulation.

Material and methods: One hundred and ninety-four overweight/obese children with suspected liver disease were included in the study. MASLD was diagnosed according to the latest consensus. Diagnosis of metabolic syndrome (MetS) was based on the International Diabetes Federation criteria in children aged ≥ 10 years (n = 182).

Results: MASLD was diagnosed in 68.56% and MetS in 26.92% of patients. Children with MASLD had significantly higher values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (GGT), total cholesterol, triglycerides (TG), UA and carotid intima-media thickness (IMT). Significantly higher levels of insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and UA were observed in patients with MetS. Correlations were observed between UA and ALT, AST, GGT, TG, insulin, HOMA-IR, mean IMT, body mass index (BMI) and high-density lipoprotein cholesterol (HDL-C) in overweight and obese children. UA was helpful in differentiating between children with MetS and without MetS (p = 0.0003), while only borderline statistical significance was observed for MASLD (p = 0.05).

Conclusions: Our results suggest that UA may be a potential additional and readily available marker of metabolic dysfunction in children with MASLD. Further studies on a larger group of patients are needed to confirm this association.