Hyperuricemia and nonalcoholic fatty liver disease: from bedside to bench and back.

Uric acid is the end product of dietary or endogenous purines degradation, and hyperuricemia is one of the most common metabolic disorders. It has been widely accepted that hyperuricemia increases risks of gout, cardiovascular diseases, and type 2 diabetes. A growing body of evidence, comprising a great deal of cross-sectional studies and several prospective ones, also indicates that hyperuricemia is associated with increased prevalence, incidence and disease severity of non-alcoholic fatty liver disease (NAFLD). On the contrary, NAFLD can predict hyperuricemia as well. However, no causal relationship can be drawn from this point. With a well-established relationship between uric acid and NAFLD prevalence as well as disease severity in addition to the role of potential therapeutic target, the prognostic role of uric acid is also worth investigating. Further studies should focus on the prospective role of uric acid on NAFLD progression and its underlying mechanisms, as well as its clinical implications.