Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease

医学 非酒精性脂肪肝 内科学 肾功能 肾脏疾病 胃肠病学 肝硬化 瞬态弹性成像 代谢综合征 脂肪肝 糖尿病前期 空腹血糖受损 糖耐量受损 糖尿病 2型糖尿病 内分泌学 疾病 胰岛素抵抗 肥胖 肝纤维化
作者
Chao Sun,George Boon‐Bee Goh,Wan‐Cheng Chow,Wah‐Kheong Chan,Grace Lai‐Hung Wong,Wai‐Kay Seto,Yi‐Hsiang Huang,Han‐Chieh Lin,I‐Cheng Lee,Hye Won Lee,Seung Up Kim,Vincent Wai‐Sun Wong,Jian‐Gao Fan
出处
期刊:Hepatobiliary & Pancreatic Diseases International [Elsevier BV]
卷期号:23 (3): 241-248 被引量:2
标识
DOI:10.1016/j.hbpd.2023.08.004
摘要

Nonalcoholic fatty liver disease (NAFLD) is associated with impaired renal function, and both diseases often occur alongside other metabolic disorders. However, the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear. The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients. All adults aged 18–70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study. Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase (FAST), Agile 3+ and Agile 4 scores. Impaired renal function and chronic kidney disease (CKD) were defined by an estimated glomerular filtration rate (eGFR) with value of < 90 mL/min/1.73 m2 and < 60 mL/min/1.73 m2, respectively, as estimated by the CKD-Epidemiology Collaboration (CKD-EPI) equation. Among 529 included NAFLD patients, the prevalence rates of impaired renal function and CKD were 37.4% and 4.9%, respectively. In multivariate analysis, a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile3+ and Agile 4 scores were independent risk factors for CKD (P < 0.05). Furthermore, increased fasting plasma glucose (FPG) and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome (P < 0.05). Compared with patients with normoglycemia, those with prediabetes [FPG ≥ 5.6 mmol/L or hemoglobin A1c (HbA1c) ≥ 5.7%] were more likely to have impaired renal function (P < 0.05). Agile 3+ and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD. Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.
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