ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) is a leading cause of liver‐related morbidity and mortality worldwide. Hyperuricemia, characterized by elevated levels of uric acid, is increasingly recognized as a key mediator linking metabolic dysfunction to liver and systemic complications. Elevated uric acid levels have been frequently observed in patients with MASLD, and there is growing evidence that hyperuricemia is not merely a byproduct but also an active factor involved in the pathogenesis of MASLD and its associated comorbidities. Recent studies have shown a significant correlation between elevated uric acid levels and the severity of liver disease in patients with MASLD, with higher uric acid levels associated with increased liver fat content and more severe histological features. Moreover, hyperuricemia has been identified as an independent predictor of adverse outcomes in MASLD, including the development of hepatocellular carcinoma (HCC) and liver‐related mortality. The relationship between uric acid and MASLD is multifaceted and involves several pathophysiological pathways, including inflammation and oxidative stress, which are critical factors in the development of liver steatosis and fibrosis. Therefore, in this study, we review the relevant progress in MASLD research, outline the concept and epidemiology of MASLD, discuss the correlation between changes in uric acid levels and the prognosis of patients with MASLD and the potential underlying mechanism, and consider future improvements in its clinical diagnosis and treatment. The goal of this review is to provide a reference for scientific research and clinical practice to promote a more in‐depth understanding of the disease and more effective clinical management.
Wang et al. (Fri,) studied this question.