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Increased frequency of hepatic steatosis and fibrosis in patients with gout detected by transient elastography

1, 2, 3, 4, 5


  1. Division of Rheumatology, Department of Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
  2. Department of Medicine, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA.
  3. Division of Gastroenterology, Department of Medicine, Rutgers-Robert Wood Johnson School of Medicine, New Brunswick, NJ, USA.
  4. Independent consultant, Sydney, Australia.
  5. AMPEL BioSolutions, LLC, Charlottesville, VA, USA.

2024 Vol.42, N°1
PI 0086, PF 0091
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PMID: 37497724 [PubMed]

Received: 03/05/2023
Accepted : 03/07/2023
In Press: 24/07/2023
Published: 24/01/2024


It has been suggested that gout is associated with non-alcoholic fatty liver disease (NAFLD). Our aim was to assess NAFLD in gout patients using the validated non-invasive imaging technique, transient elastography (FibroScan).
FibroScans in consecutive gout patients in a single centre from 11/1/2016 to 11/1/2021 and reviewed retrospectively. FibroScan results include the E- score (kPA), measuring liver stiffness, and controlled attenuation parameter (CAP) score (dB/m), assessing steatosis. In addition, a FIB-4 fibrosis score was calculated.
47 gout patients (7 females, 14.9%; 40 males, 85.1%) underwent FibroScans. The mean age was 59.8 years, the mean body mass index (BMI) was 30.95 kg/m2, and gout duration 0–49 years. Tophi were present in 11 (26.2%). Comorbidities included dyslipidaemia (86.7%), diabetes mellitus (31.1%), known liver disease (33.3%), current alcohol consumption (46.8%), ALT or AST elevations (54.4%), and hyperuricaemia (53.7%). FibroScan results revealed hepatic steatosis (CAP >238 dB/m) in 40 (85.1%) and were significantly associated with BMI (r=0.53, p=0.0001) but not age, serum urate (SU), glucose, triglycerides, ALT, AST. FibroScan also revealed fibrosis (E score >7) in 9 (19.1%); severe fibrosis (cirrhosis) in 8. Fibrosis was significantly associated with age (p=0.03) and known liver disease (p=0.003) but not BMI, SU, or comorbidities. The FIB-4 score was significantly associated with the fibrosis score (r2=0.24, p=0.0009) but not with CAP, ALT, or AST.
Despite not being associated with common gout comorbidities, fatty liver and liver fibrosis were common in this gout cohort, suggesting FibroScan screening in gout patients to assess NAFLD, irrespective of serum transaminase levels.


Rheumatology Article