Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2020; 26(15): 1683-1690
Published online Apr 21, 2020. doi: 10.3748/wjg.v26.i15.1683
Determining the role for uric acid in non-alcoholic steatohepatitis development and the utility of urate metabolites in diagnosis: An opinion review
Paul Brennan, Kathleen Clare, Jacob George, John F Dillon
Paul Brennan, Jacob George, John F Dillon, Department of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom
Kathleen Clare, Department of Neurology, Queen Elizabeth Hospital, Glasgow G51 4TF, United Kingdom
Author contributions: Brennan P and Clare K contributed equally to the research, data acquisition and writing of the paper; George J and Dillon JF provided oversight of the works and manuscript appraisal; all authors agreed the final version of the paper.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Paul Brennan, MBChB, MRCP, Doctor, Department of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Kirsty Semple Way, Dundee DD1 9SY, United Kingdom. p.z.brennan@dundee.ac.uk
Received: December 4, 2019
Peer-review started: December 31, 2019
First decision: March 6, 2020
Revised: April 2, 2020
Accepted: April 8, 2020
Article in press: April 8, 2020
Published online: April 21, 2020
Processing time: 111 Days and 10 Hours
Abstract

There has long been a recognised association between non-alcoholic fatty liver disease (NAFLD) and the composite aspects of the metabolic syndrome. Part of this association highlighted the supposed co-existence of elevated uric acid levels in those with NAFLD. There is interest in exploitation of this as a putative diagnostic and prognostic biomarker in NAFLD. Given the increased economic and health burden associated with the NAFLD epidemic, improved methods of population-based, minimally-invasive methods and biomarkers are clearly highly sought and necessary. In this opinion review we review the proposed role of uric acid in the pathogenesis of NAFLD and its potential utilisation in the diagnosis and monitoring of the disease process.

Keywords: Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Uric acid; Urate; Non-invasive fibrosis markers; Fatty liver index

Core tip: There is significant interest in the role of uric acid as both a causative aetiological proponent in non-alcoholic fatty liver disease as well as its diagnostic utility in the diagnosis of fatty liver disease. Within this review we explore these putative molecular mechanisms which are likely implicated, in addition to exploring the most recent translational evidence of uric acid as a diagnostic tool in the clinical environ.