Univariate general linear model was performed to adjust the significant findings for baseline differences as referred above. Reductions in serum total cholesterol, LDL-C, non–HDL-C, triglycerides, and uric acid levels by curcumin remained significant after adjustment for baseline values of the respective parameter (P < 0.05).
Several observational studies have reported a significant association between elevated uric acid levels and NAFLD.38–41 In addition, it has been demonstrated that uric acid promotes both lipoprotein oxidation and inflammation,42,43 2 factors that are associated with the “second-hit” of NAFLD pathogenesis.44 Consistent with the present results, a previous study in animal models of NAFLD showed improvement of hepatic steatosis and reduction of uric acid levels following hypouricemic therapy with allopurinol and benzbromarone.45 Therefore, the evidence supports the hypothesis that uric acid might play a causal role in the pathogenesis of NAFLD because it exerts prooxidant and proinflammatory effects through activation of mitogen-activated protein kinase and nuclear factor κB pathways38 and increasing the production of monocyte chemotactic protein-1.42
The authors are grateful for the supports provided by the Baqiyatallah University of Medical Sciences (Tehran, Iran) and Indena SpA (Milan, Italy).
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