The Correlation Between Serum Uric Acid Level And The Uric Acid-To-Creatinine Ratio In Paediatrics With Non-Alcoholic Fatty Liver Disease Running Title: Fatty Liver in Children with Obesity

It has been demonstrated that elevated serum uric acid (sUA) levels elicit both pro-inflammatory and pro-oxidative effects. A growing body of evidence suggests that this may play a contributory role in the development of Non-alcoholic fatty liver disease (NAFLD) in children with obesity. The objective of the present study was to evaluate the association between paediatric NAFLD and sUA levels and the sUA/creatinine (Cr) ratio. This single-center, cross-sectional, comparative study was conducted at the tertiary care center. The study cohort comprised 228 patients with obesity (body mass index (BMI) ≥ 95th percentile) and 167 controls, matched for age, sex and pubertal stage. A diagnosis of NAFLD was made following an ultrasound examination of the liver, with other possible causes of hepatic disease excluded. A significantly elevated level of sUA, and sUA/Cr values was observed in the group of patients with obesity in comparison to the control group (p < 0.001). In the group with obesity, NAFLD was detected by abdominal ultrasonography in 169 (74.1%) patients, whereas NAFLD was not detected in 59 (25.8%) patients. The levels of sUA and sUA/Cr were significantly elevated in the obese NAFLD group in comparison to the obese non-NAFLD and control groups (p < 0.001). An elevated WC, ALT, and the ratio of sUA/Cr are associated with an increased risk of NAFLD. A one-unit increase in sUA/Cr was found to be associated with an increased risk of NAFLD (OR = 1.323, 95% CI: 1.001–1.748).The findings of our study indicate that an elevated WC, ALT, and the ratio of sUA/Cr are associated with an increased risk of NAFLD. Nevertheless, no such correlation was identified between sUA and NAFLD.