Hyperuricaemia could be a risk factor for T2DM, but
a causal link remains controversial. Thus, there are studies
concluding an association, no association, and even
an inverse association, and have been reviewed recently
by Li et al. [56]. Obesity is associated with reduced lifeexpectancy,
largely because of the increased risk of cardiovascular
disease. However, approximately a third of
obese individuals do not develop cardiovascular disease.
This group is generally referred to as the ‘metabolically
healthy obese’. In a recent study, serum urate was the
best predictor of ‘metabolically unhealthy obesity’ (defined
as having features of the metabolic syndrome), with increased
cardiovascular risk in adolescents and adults [67].
Some studies also suggest an independent association between
non-alcoholic fatty liver disease (NAFLD) and hyperuricaemia
[68]. Hyperuricaemia is also independently
associated with the severity of steatosis and a poor response
to therapy in patients with chronic hepatitis C infection
[69].