These were cross-sectional studies designed to assess the health and nutritional status of the noninstitutionalized US population.3 Participants completed personal, structured interviews at home and then attended a mobile examination center at multiple ABT888 locations throughout the United States to undergo various examinations and provide blood samples. Among 14,407 NHANES I participants (25-74 years old), 13,861 were successfully traced on at least one of four follow-up occasions (1982-1984, 1986, 1987, or 1992). We attempted to exclude participants who suffered from cirrhosis at the time of entry into the study by excluding participants who, at the baseline, reported ever being

told by a physician that they had jaundice (n = 886) or hepatitis (n = 47), who had this website hepatomegaly or splenomegaly at the baseline examination (n = 237), or whose level of serum albumin was less than 3 g/dL (n = 10). Serum bilirubin levels and platelet counts, which may be abnormal in advanced cirrhosis, were available only in a small minority of participants and therefore could not be used to identify participants with possible cirrhosis. Because cirrhosis may be present for a long time before it is clinically diagnosed, we also excluded participants who were

diagnosed with cirrhosis within the first 4 years of follow-up or who had less than 4 years of follow-up (n = 687). We excluded 47 participants who had a malignant tumor and 90 with missing values in potential confounding variables. Serum UA levels were measured only in a subsample of participants, so 6339 participants did not have serum UA measurements; this left 5518 participants in the current analyses. Of 16,884 NHANES 1988-1994 participants who were 25 years old or older, we excluded 168 pregnant selleck screening library women and participants

with missing data for viral hepatitis B or C serologies (n = 2861), educational attainment (n = 186), alcohol consumption (n = 560), body mass index (BMI; n = 24), waist circumference (n = 474), diabetes (n = 9), coffee consumption (n = 18), and serum UA (n = 104). We excluded persons who fasted for ≤6 hours or lacked measurements for fasting serum insulin and plasma glucose (n = 1487); this left 10,993 persons for serum ALT analyses. Serum GGT testing was added to the NHANES 1988-1994 protocol after the study began, so serum GGT levels were not available in an additional 2359 participants; this left 8634 participants for serum GGT analyses. Identical inclusion and exclusion criteria resulted in 6186 participants for both serum GGT and ALT analyses in NHANES 1999-2006. In NHANES I, serum UA was measured with an automated colorimetric phosphotungstic acid procedure, which had been validated against the uricase assay, on a Technicon SMA 12-60 (Technicon Instruments, Tarrytown, NY). In NHANES 1988-1994 and NHANES 1999-2006, serum UA was measured by oxidation with the specific enzyme uricase to form allantoin and hydrogen peroxide.