Prediction of insulin resistance and non-alcoholic fatty liver disease using serum uric acid and related markers in children and adolescents

Abstract Objective To investigate the relationship between serum uric acid (Uacid) and related parameters with insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD)and their potential as predictors of IR and NAFLD in children and adolescents Methods The data of 1,648 participants aged 10–18 years was analyzed using nationwide survey. Logistic regression analysis was performed with IR and NAFLD as dependent variables, and odds ratios (ORs) and 95% confidence intervals (CIs) were computed for tertiles 2 and 3 of each parameter in comparison to tertile 1, which served as the reference group. Receiver operating characteristic (ROC) curves were generated to assess predictability of the parameters for IR and NAFLD. Results Hyperuricemia, IR, and NAFLD were significantly associated each other. All Uacid and related markers showed continuous increase in ORs and 95% CIs across the tertiles for IR and NAFLD (all p < 0.001). In ROC curve, all Uacid and related markers demonstrated significant predictability for IR and NAFLD. Overall, Uacid combined with obesity indices showed higher ORs and AUC compared to Uacid alone. Uacid-body mass index (BMI) standard deviation score presented the largest AUC for IR. For NAFLD, Uacid-BMI and Uacid-waist-to-height ratio showed the largest AUC. Conclusions Uacid combined with obesity indices are robust markers for prediction of IR and NAFLD in children and adolescents, which was superior to Uacid. Uacid and related markers have potential as simple markers which does not require fasting for screening of IR and NAFLD in children and adolescents