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非酒精性脂肪性肝病与无糖尿病男性的低级别白蛋白尿有关。

Non-alcoholic fatty liver disease is associated with low-grade albuminuria in men without diabetes mellitus.

机构信息

Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea.

出版信息

Int J Med Sci. 2019 Jan 1;16(2):285-291. doi: 10.7150/ijms.28264. eCollection 2019.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is associated with the dysregulation of multiple metabolic and inflammatory pathways. These can lead to extrahepatic disorders involving the kidney, a vulnerable organ responsible for extra-renal complications. Evaluating the association between NAFLD and low-grade albuminuria as a renal complication would be helpful to better understand the pathophysiology and extra-hepatic complications of NAFLD. Our study extracted data from database obtained a representative population sample. Overall, 3867 men were included in this survey. Our study included only men without diabetes mellitus, with a urinary albumin/creatinine ratio < 30 mg/g (n = 1390). Low-grade albuminuria was defined by a urinary albumin/creatinine ratio within the highest quartile. The fatty liver index was calculated in accordance with Bedogni's equation. We defined the NAFLD group as patients with a fatty liver index of ≥ 60. In the multivariate analysis, the urinary albumin/creatinine ratio in the non-NAFLD and NAFLD groups was 3.05 ± 0.14 and 5.19 ± 0.42, respectively ( < 0.001). The correlation coefficients between the fatty liver index and urinary albumin/creatinine ratio were 0.124 in the Pearson's correlation test and 0.084 in the partial correlation test ( < 0.001 and = 0.002, respectively). Linear regression analysis showed a positive association between the fatty liver index and the urinary albumin/creatinine ratio on multivariate analysis. Logistic regression analysis showed that the odds ratio for low-grade albuminuria with NAFLD was 2.31 (95% confidence interval, 1.47-3.61; < 0.001) on the multivariate analysis. Subgroup analyses according to the presence of metabolic syndrome or age (< 50 or ≥ 50 years) showed that the association between NAFLD and the urinary albumin/creatinine ratio was stronger for participants without metabolic syndrome and in those aged < 50 years. NAFLD was associated with low-grade albuminuria in men without diabetes mellitus in this study. Therefore, men with a relatively high fatty liver index or NAFLD should be closely monitored for low-grade albuminuria, especially in absence of metabolic syndrome.

摘要

非酒精性脂肪性肝病 (NAFLD) 与多种代谢和炎症途径的失调有关。这些途径可能导致涉及肾脏的肝外疾病,肾脏是负责肾外并发症的脆弱器官。评估 NAFLD 与低级别白蛋白尿作为肾外并发症之间的关联,有助于更好地理解 NAFLD 的病理生理学和肝外并发症。我们的研究从数据库中提取数据,获得了具有代表性的人群样本。总体而言,这项调查纳入了 3867 名男性。我们的研究仅包括没有糖尿病且尿白蛋白/肌酐比值 < 30 mg/g 的男性(n = 1390)。低级别白蛋白尿定义为尿白蛋白/肌酐比值处于最高四分位区间内。脂肪肝指数按照 Bedogni 方程计算。我们将 NAFLD 组定义为脂肪肝指数≥60 的患者。在多变量分析中,非 NAFLD 和 NAFLD 组的尿白蛋白/肌酐比值分别为 3.05 ± 0.14 和 5.19 ± 0.42(<0.001)。Pearson 相关检验中脂肪肝指数与尿白蛋白/肌酐比值的相关系数为 0.124,偏相关检验中的相关系数为 0.084(均<0.001,=0.002)。多元线性回归分析显示,多元分析中脂肪肝指数与尿白蛋白/肌酐比值呈正相关。Logistic 回归分析显示,NAFLD 患者发生低级别白蛋白尿的比值比为 2.31(95%置信区间,1.47-3.61;<0.001)。根据代谢综合征的存在或年龄(<50 岁或≥50 岁)进行亚组分析显示,在无代谢综合征和年龄<50 岁的患者中,NAFLD 与尿白蛋白/肌酐比值之间的相关性更强。在本研究中,男性非酒精性脂肪性肝病与低级别白蛋白尿相关。因此,在这些男性中,具有相对较高的脂肪肝指数或 NAFLD 的患者应密切监测低级别白蛋白尿,尤其是在没有代谢综合征的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ce6/6367539/a070b5265700/ijmsv16p0285g001.jpg

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