A growing public health problem, metabolic dysfunction-associated fatty liver disease is intimately related to obesity, insulin resistance, and other elements of metabolic syndrome. Growing research indicates that MAFLD may considerably raise the risk of extrahepatic disorders, such as gout, in addition to liver-related problems. MAFLD and gout, a type of inflammatory arthritis brought on by high blood uric acid levels, overlap metabolic pathways, especially in regard to insulin resistance and lipid abnormalities.
Investigating this relationship might potentially reveal common processes and possible treatment targets. The relationship between MASLD and incident gout risk is thoroughly investigated in this first prospective cohort research in Europe.
This study used UK Biobank data (n = 402,083 after exclusions), omitting individuals with baseline gout, arthritis, hepatitis B/C, alcohol-related liver illness, or incidents during the first two-year follow-up. MASLD–gout relationships were assessed using Cox proportional hazards models, and cumulative incidence was represented by Kaplan–Meier curves.
When compared to their non-MASLD peers, MASLD patients had a 71% higher incidence of gout (HR = 1.71, 95% CI 1.59–1.83, P < 0.0001). Subgroup analyses showed significant correlations across demographics, with older persons having a lower risk (≥65 years: HR = 1.55 vs. <65 years: HR = 1.86).
Ironically, those without central obesity, diabetes, or hypertension showed a greater chance of developing gout than people with these conditions. Over time, the cumulative incidence of gout was considerably higher among MASLD patients (P<0.001). Overall, MASLD was significantly linked to a higher incidence of gout. MASLD was still linked to a markedly higher incidence of gout even after controlling for covariates.
Gout in MASLD patients may be influenced by a number of factors, including sex, age, BMI, alcohol and smoking status, hypertension, diabetes, and central obesity. These results imply that elucidating this link may have significant therapeutic consequences for gout prevention and treatment, as well as preventing the elevated risk of gout-induced chronic illnesses by MASLD-focused therapies.
Source:
Liu, X., Wang, Y., Song, H., Tian, Z.-B., Wang, Y.-G., Yu, Q., Li, C., Niu, Q., Zhu, X.-J., & Chen, Y. (2025). Metabolic dysfunction-associated fatty liver disease and the risk of gout: a UK Biobank prospective cohort study. European Journal of Medical Research, 30(1), 1027. https://doi.org/10.1186/s40001-025-03298-5
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