Curr Hypertens Rev. 2026 Mar 18. doi: 10.2174/0115734021422803260202113520. Online ahead of print.
ABSTRACT
INTRODUCTION/OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a rapid increase in cases worldwide. NAFLD has recently emerged as an important driving force in the development and progression of hypertension. The uric acid-toalbumin ratio (UAR) is a new marker of cardiovascular disease. The present study aimed to assess the relationship between UAR and hypertension in patients with NAFLD.
METHODS: The present prospective case-control study included 200 NAFLD patients. In addition, there were 100 age- and sex-matched controls. NAFLD was diagnosed on the basis of evidence of fatty liver infiltration shown by ultrasound in the absence of significant alcohol intake (maximum 30 g/day in males and 20 g/day in females) and other possible causes of fatty liver disease. Hypertension was diagnosed according to the recommendations of the 2020 International Society of Hypertension Global Hypertension Practice Guidelines. UAR was calculated by dividing uric acid levels (mg/dL) by serum albumin levels (g/dL). Group comparisons were performed using the independent samples t-test for continuous variables and the chi-square test for categorical variables. Binary logistic regression was used for multivariate analysis.
RESULTS: Comparison between patients and controls revealed that patients had significantly higher UAR than controls (1.46 ± 0.35 versus 1.34 ± 0.28, p=0.001). The NAFLD group included 71 hypertensive patients (35.5 %). Hypertensive patients had significantly higher UAR than normotensive counterparts (1.56 ± 0.38 versus 1.41 ± 0.32 mg/g, p=0.005). Binary logistic analysis identified obesity (OR (95% CI): 9.68 (3.92-23.92), p<0.001), diabetes mellitus (DM) (OR (95% CI): 3.08 (1.56- 6.12), p=0.001) and elevated UAR (OR (95% CI): 11.12 (3.62-34.19), p<0.001) as significant predictors of hypertension in the studied patients in multivariate analysis.
DISCUSSION: The present study identified the trio of obesity, diabetes mellitus, and elevated UAR as predictors of hypertension in multivariate analysis, consistent with multiple previous reports.
CONCLUSIONS: UAR may serve as a valuable, readily available marker that can predict hypertension in NAFLD patients, particularly those with associated diabetes and obesity.
PMID:41863126 | DOI:10.2174/0115734021422803260202113520