Kasapoglu Benan, Turkay Cansel, Yalcın Kadir Serkan, Boga Salih, Bozkurt Alper
a Department of Internal Medicine , Division of Gastroenterology, Turgut Ozal University Medical School , Ankara , Turkey .
b Department of Internal Medicine , Division of Gastroenterology, Sisli Etfal Education and Research Hospital , Istanbul , Turkey , and.
Ren Fail. 2016;38(1):15-9. doi: 10.3109/0886022X.2015.1106845. Epub 2015 Nov 5.
To determine the prevalence of microalbuminuria, that is an indirect predictor of coronary artery disease, among non-obese and non-diabetic patients with fatty liver disease.
This retrospective study was carried out on non-obese (body mass index (BMI) < 30) and non-diabetic 290 female and 189 male, totally 479 cases. All subjects underwent liver ultrasonography scanning to determine the presence and stage of fatty liver disease.
The subjects were grouped according to the ultrasound findings as follows: 182 (37.9%) cases without any fat accumulation in liver were regarded as control group; and among remaining cases, 124 (25.8%) had mild, 93 (19.4%) had moderate, and 80 (16.7%) had severe fatty liver disease. There was not any statistically significant difference between groups in regards to the age, gender, liver function tests, renal function tests or glomerular filtration rate. However urinary protein/creatinine ratio was statistically significantly higher in severe nonalcoholic fatty liver disease (NAFLD) group than the other three groups. In moderate and severe NAFLD groups, microalbuminuria was statistically significantly more common compared with the control and mild NAFLD groups. Regarding the results of multiple logistic regression analysis, presence of fatty liver disease increased the risk of microalbuminuria for 1.87 times independently from increased BMI and increased HOMA-IR values.
We have determined that microalbuminuria is more prevalent among NAFLD cases compared with control cases and microalbuminuria prevalence was increasing with the advanced stages of NAFLD although two main etiologic factors of microalbuminuria, type 2 diabetes, and obesity were excluded.
确定非肥胖且非糖尿病的脂肪肝患者中微量白蛋白尿的患病率，微量白蛋白尿是冠状动脉疾病的间接预测指标。
本回顾性研究针对479例非肥胖（体重指数（BMI）<30）且非糖尿病的患者开展，其中女性290例，男性189例。所有受试者均接受肝脏超声扫描以确定脂肪肝疾病的存在及阶段。
根据超声检查结果将受试者分组如下：182例（37.9%）肝脏无脂肪堆积的病例被视为对照组；其余病例中，124例（25.8%）为轻度脂肪肝，93例（19.4%）为中度脂肪肝，80例（16.7%）为重度脂肪肝。各组在年龄、性别、肝功能检查、肾功能检查或肾小球滤过率方面无统计学显著差异。然而，重度非酒精性脂肪性肝病（NAFLD）组的尿蛋白/肌酐比值在统计学上显著高于其他三组。在中度和重度NAFLD组中，与对照组和轻度NAFLD组相比，微量白蛋白尿在统计学上更为常见。关于多元逻辑回归分析结果，脂肪肝疾病的存在使微量白蛋白尿风险独立于BMI增加和HOMA-IR值增加而增加1.87倍。
我们已确定，与对照组相比，微量白蛋白尿在NAFLD病例中更为普遍，并且尽管排除了微量白蛋白尿的两个主要病因因素——2型糖尿病和肥胖，但微量白蛋白尿患病率随着NAFLD的进展阶段而增加。
