Evidence map›Paper›PMID 42501272›Full record

ArticleHepatology international2026

Gout is independently associated with occult hepatic fibro-inflammation independent of obesity: a multi-cohort study using MRI-cT1 and elastography.

Yixian Mei, Weiqi Cai, Qiming Huang, Qingduo Chen, Yongxu Lin, Yaqing Chen, Chenyu Xin, Cunyu Lu, Zheshu Chen, Xiaoping Chen and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Yixian Mei *Digestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Weiqi Cai *Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
Qiming Huang *Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China.
Qingduo ChenDigestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Yongxu LinDepartment of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
Yaqing ChenZhangzhou Yuanshan Hospital, Zhangzhou High-Tech Zone (Hi-Tech Zone), Zhangzhou City, Fujian Province, China.
Chenyu XinDigestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Cunyu LuDigestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Zheshu ChenDigestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
Xiaoping ChenSchool of Computer Science and Mathematics, FuJian University of Technology, Fuzhou, China.
Jian DingDepartment of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, Fujian Province, China.
Qiuyuan LiuDepartment of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui Province, China. yfy1152846@fy.ahmu.edu.cn.
Dan LiDigestive Department, Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases, Fujian Medical University Union Hospital, Fuzhou, 350001, China. doctorlidan99@fjmu.edu.cn.ORCID http://orcid.org/0000-0003-1975-3785

Funding

Fujian Clinical Research Center for Digestive System Tumors and Upper Gastrointestinal Diseases 2022YGPT004National Key Clinical Specialty Construction Projects of Fujian Province, China 2023-1594the Joint Funds for the Innovation of Science and Technology, Fujian province 2021Y9064
6 · The paper itself

Abstract

BACKGROUND AND

aimsGout frequently co-occurs with steatotic liver disease, but its direct hepatotoxic effect beyond obesity remains contentious. We aimed to elucidate the independent association between gout and hepatic fibro-inflammation, particularly in subclinical cases with normal alanine aminotransferase (ALT).

methodsThis multi-cohort study integrated a UK Biobank discovery cohort (N = 21,334) using MRI iron-corrected T1 (cT1) mapping, and a multicenter clinical validation cohort (N = 512) using Transient Elastography (FibroScan) to measure liver stiffness (LSM). Multivariable regression and causal mediation analyses dissected "obesity-dependent" versus "independent" pathways.

resultsGout patients exhibited significantly elevated liver fibro-inflammation and steatosis across both cohorts. After full adjustment for metabolic confounders, gout was independently associated with liver injury in the UK Biobank (β-cT1 = 6.41 ms, p = 0.025) and clinical cohort (β-LSM = 1.21 kPa, p < 0.001). This association consistently persisted in non-obese patients with normal ALT (< 40 U/L), indicating occult injury. Mediation analysis revealed a "Double Hit" mechanism: 51.3% of the effect was obesity-mediated, while 48.7% was independent of body mass index.

conclusionGout is an independent factor associated with subclinical hepatic fibro-inflammation, even in non-obese, normo-enzymatic patients. This challenges reliance on ALT screening alone, warranting the integration of sensitive liver health assessments into routine gout management.

Indexed as

AsymptomaticDouble HitFibroScanGoutHepatic fibro-inflammationMetabolic dysfunction-associated steatotic liver diseaseMRI-cT1Non-invasive imagingOccult liver injuryUric acid

Identifiers

PMID42501272

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.