Valor pronóstico de uricemia para enfermedad hepática grasa asociada a disfunción metabólica
Resumen
Introducción: Evidencia epidemiológica muestra la asociación entre Esteatosis Hepática Asociada a Disfunción Metabólica (EHADM) y elevación de la uricemia. Objetivo: Determinar valor pronóstico de la uricemia para EHADM. Métodos: Estudio epidemiológico de tipo corte transversal, caso-control. 47 sujetos de ambos sexos, con edad de 18-75 años, fueron clasificados según la presencia de EHADM (casos, n=24) o ausencia de EHADM (controles, NEHADM, n=23). Se evaluó: la concentración sérica de ácido úrico (Au) y biomarcadores para enfermedad metabólica, la fibrosis hepática por elastografía de onda de corte ultrasonográfica y el valor límite para uricemia asociada a EHADM con base en la curva característica del operador receptor. Resultados: La EHADM fue mayor en mujeres (55.26 % contra 33.33 % en hombres). La dislipidemia por HDL-colesterol (98%) y obesidad abdominal (76.59%) fueron los factores de riesgo más frecuentes para EHADM. La EHADM se correlacionó positivamente con el diámetro longitudinal de lóbulo hepático derecho (LHD) y el índice HOMA (p =0.006); uricemia y Au/HDLc (p = 0.0001). El promedio de uricemia en EHADM (7,49±1,82 mg/dl; IC95% 6,76- 8,21 mg/dL), fue mayor que en NEHDAM (5,37±1,06 mg/dl; IC95% 4.94-5.80 mg/dL, p = 0.0001, prueba t de Student, alfa = 0.05). El valor límite para uricemia asociada a EHADM fue de 6.02 mg/dL (sensibilidad 70.83%; especificidad 82.61%; VPP 80.95% y VPN 73.08%, RR 3.01); y para LHD de 13.15 cm (sensibilidad 62.50%; especificidad 73.91%; VPP 71.43% y VPN 65.38 %, RR 2.06). Conclusión: Se muestran valores límites de uricemia y de la longitud del lóbulo hepático derecho asociados a EHADM.
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