Impact of non‐alcoholic fatty liver disease and fibrosis on mortality and kidney outcomes in patients with type 2 diabetes and chronic kidney disease: A multi‐cohort longitudinal study

医学 内科学 危险系数 肾脏疾病 脂肪肝 队列 2型糖尿病 孟德尔随机化 肝活检 全国健康与营养检查调查 比例危险模型 队列研究 糖尿病 胃肠病学 疾病 置信区间 活检 人口 内分泌学 环境卫生 化学 基因型 基因 生物化学 遗传变异
作者
Lijun Zhao,Qingyue Zeng,Xiaoqin Zhou,Linqiao Tang,Yujia Wang,Qianqian Han,Yutong Zou,Xiang Xiao,Ke Liu,Xuegui Ju,Yucheng Wu,Hongqiang Li,Chuanyi Zhao,Fang Liu
出处
期刊:Diabetes, Obesity and Metabolism [Wiley]
卷期号:26 (10): 4241-4250 被引量:3
标识
DOI:10.1111/dom.15758
摘要

Abstract Aim To evaluate the impact of non‐alcoholic fatty liver disease (NAFLD) presence and fibrosis risk on adverse outcomes in patients with type 2 diabetes and chronic kidney disease. Methods Data were sourced from two longitudinal cohorts: 1172 patients from the National Health and Nutrition Examination Survey (NHANES) and 326 patients from the kidney biopsy cohort at the West China Hospital of Sichuan University. Cox regression estimated hazard ratios (HRs) for NAFLD and liver fibrosis concerning adverse clinical outcomes. Subsequently, a two‐sample Mendelian randomization study using genome‐wide association study statistics explored NAFLD's potential causal link to cardio‐cerebrovascular events. Results In the NHANES cohort, NAFLD stood as an independent risk factor for various outcomes: overall mortality [HR 1.53 (95% confidence interval, CI 1.21‐1.95)], mortality because of cardio‐cerebrovascular diseases [HR 1.63 (95% CI 1.12‐2.37)], heart disease [HR 1.58 (95% CI 1.00‐2.49)], and cerebrovascular disease [HR 3.95 (95% CI 1.48‐10.55)]. Notably, advanced liver fibrosis, identified by a fibrosis‐4 (FIB‐4) score >2.67, exhibited associations with overall mortality, cardio‐cerebrovascular disease mortality and heart disease mortality. Within the kidney biopsy cohort, NAFLD correlated with future end‐stage kidney disease [ESKD; HR 2.17 (95% CI 1.41‐3.34)], while elevated FIB‐4 or NAFLD Fibrosis Scores predicted future ESKD, following full adjustment. Liver fibrosis was positively correlated with renal interstitial fibrosis and tubular atrophy in biopsies. Further Mendelian randomization analysis supported a causal relationship between NAFLD and cardio‐cerebrovascular events. Conclusions In patients with type 2 diabetes and chronic kidney disease, the NAFLD presence and elevated FIB‐4 scores link to heightened mortality risk and ESKD susceptibility. Moreover, NAFLD shows a causal relationship with cardio‐cerebrovascular events.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
sdl完成签到,获得积分10
刚刚
Orange应助孟婆的碗采纳,获得10
1秒前
zhangmy1989发布了新的文献求助30
1秒前
1秒前
清秀的不言完成签到 ,获得积分10
1秒前
杂化轨道退役研究员完成签到,获得积分10
1秒前
FashionBoy应助tanglu采纳,获得10
2秒前
3秒前
闪闪如南完成签到,获得积分10
4秒前
wjxcl完成签到,获得积分10
5秒前
5秒前
5秒前
12233完成签到,获得积分10
6秒前
6秒前
洪武完成签到,获得积分20
6秒前
7秒前
Yuantian发布了新的文献求助10
8秒前
传奇3应助浪花淘尽英雄采纳,获得10
9秒前
流川枫完成签到,获得积分10
9秒前
赘婿应助leo采纳,获得10
9秒前
追寻夏烟完成签到 ,获得积分10
10秒前
闪闪寒云完成签到 ,获得积分10
10秒前
13633501455完成签到 ,获得积分10
11秒前
阿里完成签到,获得积分10
11秒前
蓁蓁发布了新的文献求助10
12秒前
科研通AI5应助加百莉采纳,获得10
12秒前
WELXCNK完成签到,获得积分10
13秒前
GG波波完成签到,获得积分10
14秒前
susu完成签到 ,获得积分10
14秒前
15秒前
15秒前
海阔天空发布了新的文献求助10
16秒前
Loooong发布了新的文献求助10
17秒前
云影箫羽完成签到 ,获得积分10
18秒前
18秒前
顾矜应助gougoutu采纳,获得10
19秒前
生生完成签到,获得积分10
19秒前
温暖芸发布了新的文献求助10
20秒前
芝麻完成签到,获得积分10
21秒前
科研小菜发布了新的文献求助10
22秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038569
求助须知:如何正确求助?哪些是违规求助? 3576279
关于积分的说明 11374944
捐赠科研通 3305979
什么是DOI,文献DOI怎么找? 1819354
邀请新用户注册赠送积分活动 892698
科研通“疑难数据库(出版商)”最低求助积分说明 815048