Lai Yu-Cheng, Cheng Ben-Chung, Hwang Jyh-Chang, Lee Yueh-Ting, Chiu Chien-Hua, Kuo Li-Chueh, Chen Jin-Bor
Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Nephron Clin Pract. 2013;124(3-4):218-23. doi: 10.1159/000357952. Epub 2014 Feb 4.
BACKGROUND/AIMS: The prevalence of cardiovascular (CV) disease in patients undergoing maintenance hemodialysis (HD) is reportedly higher than that in healthy individuals. In the present study, we aimed to investigate whether ultrasonographically documented fatty liver disease (FLD) is an independent risk factor for nonfatal CV events in patients undergoing HD.
A retrospective cohort study was conducted in a medical center in southern Taiwan. The medical records of 490 patients undergoing HD who were enrolled between July 1998 and October 2012 were screened. Finally, 278 patients who had undergone hepatic ultrasonography and had available data were recruited in the present study. The patients included 130 men and 148 women; their mean age was 59.9 years. The primary endpoint was nonfatal CV events in the observation period. The comparable data included epidemiological, hematological, and biochemical profiles. A time-dependent statistical method was used to analyze the associated factors.
The prevalence of nonfatal CV events was significantly increased in the patients with FLD compared with those without FLD (CV events: 32 vs. 18%, respectively; p = 0.008). After adjusting for associated risk factors (sex, age, body mass index, smoking, diabetes, hypertension, dyslipidemia, and Kt/V), multivariate analyses identified FLD (CV events: hazard ratio 2.84, 95% confidence interval 1.52-5.28, p = 0.001), advanced age, and diabetes to be independently associated with nonfatal CV events.
The study suggests that FLD was an independent risk factor for nonfatal CV events in patients undergoing maintenance HD.
背景/目的：据报道，维持性血液透析（HD）患者心血管（CV）疾病的患病率高于健康个体。在本研究中，我们旨在调查超声记录的脂肪肝疾病（FLD）是否是HD患者非致命性CV事件的独立危险因素。
在台湾南部的一家医疗中心进行了一项回顾性队列研究。筛选了1998年7月至2012年10月期间登记的490例接受HD治疗的患者的病历。最终，本研究招募了278例接受肝脏超声检查并具有可用数据的患者。患者包括130名男性和148名女性；他们的平均年龄为59.9岁。主要终点是观察期内的非致命性CV事件。可比数据包括流行病学、血液学和生化特征。采用时间依赖性统计方法分析相关因素。
与无FLD的患者相比，FLD患者非致命性CV事件的患病率显著增加（CV事件：分别为32%和18%；p = 0.008）。在调整相关危险因素（性别、年龄、体重指数、吸烟、糖尿病、高血压、血脂异常和Kt/V）后，多变量分析确定FLD（CV事件：风险比2.84，95%置信区间1.52 - 5.28，p = 0.001）、高龄和糖尿病与非致命性CV事件独立相关。
该研究表明，FLD是维持性HD患者非致命性CV事件的独立危险因素。
