Objective  To explore the association between serum uric acid (SUA) and non-alcoholic fatty liver disease (NAFLD) among residents in Nanping city of Fujian province and to provide evidences for developing intervention on NAFLD.

  Methods  We enrolled 2 328 attendees aged 18 – 70 years at a physical examination center of a general hospital in Nanping city of Fujian province and conducted questionnaire interview, physical examination and laboratory detection among the participants from April 2015 through August 2017. In the participants, 543 NAFLD cases were diagnosed based on imaging diagnostic criteria recommended by the National Guidelines for Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease – 2010 Revision and assigned into the case group; the controls were 1 785 participants without NAFLD. Statistical analyses were performed to assess the association of SUA with NAFLD.

  Results  The SUA of the cases was significantly higher than that of the controls (375.24 ± 93.36 μmol/L vs. 313.20 ± 76.59 μmol/L, t = – 15.664; P < 0.001). The detection rates of NAFLD were 8.34%, 23.52%, 22.51%, and 43.13% for the participants in the lowest, second, third, and the highest quartile of SUA content, respectively. Unconditional multivariate logistic regression analysis revealed that compared to those in the lowest quartile of SUA content, the participants in the second and the highest quartile were at increased risk of NAFLD, with the odds ratios (95% confidence interval) of 2.05 (1.35 – 3.11) and 2.02 (1.29 – 3.17) after adjusting for gender, age, education, occupation, monthly average income, smoking, alcohol drinking, physical exercise, history of chronic diseases, body mass index, systolic pressure, diastolic pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, glutamyltranspeptidase, creatinine, and fasting blood glucose.

  Conclusion  High serum uric acid could increase the risk of non-alcoholic fatty liver disease in 18 - 70 years old population.