Pan Ling-Ling, Zhang Hui-Jie, Huang Zhu-Feng, Sun Qian, Chen Zheng, Li Zhi-Bin, Yang Shu-Yu, Li Xiao-Ying, Li Xue-Jun
Shanghai Institute of Endocrinology and Metabolism, Department of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin 2nd Road, Shanghai 200025, China.
Xiamen Diabetes Institute, Department of Endocrinology and Metabolism, The First Hospital of Xiamen, Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
Metabolism. 2015 Sep;64(9):1077-85. doi: 10.1016/j.metabol.2015.06.003. Epub 2015 Jun 10.
Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) are associated with some common critical cardio-metabolic risk factors. The aim of this study was to explore the association between intrahepatic triglyceride (IHTG) content and CKD in obese subjects.
A total of 1068 obese participants received anthropometric, biochemical measurements and hepatic ultrasonography. Of those, 485 participants received magnetic resonance spectroscopy ((1)H-MRS) for the determination of IHTG content. CKD was defined as a urinary albumin:creatinine ratio (UACR)≥30 mg/g and/or estimated glomerular filtration rate (eGFR)<60 mL/min per 1.73 m(2).
The prevalence of CKD was significantly higher in NAFLD subjects compared to subjects without NAFLD, while the prevalence of CKD was gradually increased as the IHTG content increased by quartiles (P for trend<0.001). After adjustment for multivariate metabolic factors, the risk of abnormal albuminuria and CKD was increased by 68% [OR (95% CI): 1.68 (1.21-2.33), P<0.01] and 54% [OR (95% CI): 1.54 (1.14-2.07), P<0.01] respectively per one standard deviation (SD) increase in IHTG content. The association between IHTG content and CKD was not changed by conventional risk factors, including age, BMI and hypertension (all P<0.05).
IHTG content is independently associated with CKD in obese adults.
非酒精性脂肪性肝病（NAFLD）和慢性肾脏病（CKD）与一些常见的关键心血管代谢危险因素相关。本研究旨在探讨肥胖受试者肝内甘油三酯（IHTG）含量与CKD之间的关联。
共有1068名肥胖参与者接受了人体测量、生化检测和肝脏超声检查。其中，485名参与者接受了磁共振波谱（（1）H-MRS）检查以测定IHTG含量。CKD的定义为尿白蛋白：肌酐比值（UACR）≥30 mg/g和/或估计肾小球滤过率（eGFR）<60 mL/（min·1.73 m²）。
与无NAFLD的受试者相比，NAFLD受试者的CKD患病率显著更高，而随着IHTG含量按四分位数增加，CKD患病率逐渐升高（趋势P<0.001）。在对多变量代谢因素进行校正后，IHTG含量每增加一个标准差（SD），白蛋白尿异常和CKD的风险分别增加68% [OR（95%CI）：1.68（1.21-2.33），P<0.01]和54% [OR（95%CI）：1.54（1.14-2.07），P<0.01]。IHTG含量与CKD之间的关联不受年龄、BMI和高血压等传统危险因素的影响（所有P<0.05）。
肥胖成年人的IHTG含量与CKD独立相关。
