Association of serum uric acid and serum uric acid/creatinine ratio with metabolic dysfunction-associated fatty liver disease in young adults: a retrospective study

Abstract Background Metabolic dysfunction-associatedsteatotic liver disease (MASLD) has become the most prevalent chronic liver disease worldwide. Its incidence continues to rise with a marked trend toward younger age groups, posing dual challenges for early screening and standardized diagnosis and treatment. There is an urgent clinical need for simple-to-operate, highly sensitive serological markers to enable early disease identification. Purpose This study aims to investigate the correlation between serum uric acid (SUA) and serum uric acid to creatinine ratio (SUA/Cr) levels in young adults and MASLD and its components. Methods A retrospective analysis was conducted on 5,224 individuals aged 20–45 years who underwent physical examinations at Northern Jiangsu People’s Hospital in 2019. Measured the patient’s body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), fasting blood glucose(FBG), creatinine(Cr), triglycerides(TG), total cholesterol(TC), serum uric acid(SUA), high-density lipoprotein(HDL-c) and other indicators. Logistic regression analysis was employed to investigate the correlations among SUA, SUA/Cr, and the components of MASLD in the young adults while adjusting for confounding factors. The receiver operating characteristic (ROC) curve analysis was performed to evaluate discriminatory ability. Results The levels of SUA and SUA/Cr in the MASLD cohort were significantly higher than those in the non-MASLD cohort. Elevated SUA and SUA/Cr levels were associated with components for MASLD. Both SUA (OR: 1.014, 95% CI: 1.013–1.015) and SUA/Cr (OR: 2.570, 95% CI: 2.368–2.788) were significantly associated with MASLD (P < 0.001). The Area Under Curve(AUC) values were 0.807 and 0.724, respectively. Conclusion SUA and SUA/Cr levels are significantly associated with MASLD and its components in young adults. Clinical trial number Not applicable.