脂肪肝疾病与慢性肾病之间的相关性。
The correlation between fatty liver disease and chronic kidney disease.
机构信息
Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.
出版信息
J Formos Med Assoc. 2020 Jan;119(1 Pt 1):42-50. doi: 10.1016/j.jfma.2019.02.010. Epub 2019 Mar 12.
BACKGROUND/PURPOSE: The impact of non-alcoholic fatty liver disease (NAFLD) on the prevalence of chronic kidney disease (CKD) is not fully elucidated. We aimed to assess the correlation between NAFLD and CKD in a large population study.
METHODS
We included consecutive subjects who had received health check-up service at Taipei Veterans General Hospital from 2002 to 2009. NAFLD was diagnosed with abdominal ultrasound, and advanced liver fibrosis was determined with NAFLD fibrosis score (NAFLD-FS). CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m.
RESULTS
Among the 29,797 subjects enrolled in this study, NAFLD and CKD were diagnosed in 44.5% and 20.2% of the population, respectively. Subjects with NAFLD had a higher proportion of CKD compared to those without NAFLD (24.1% vs. 17.1%, p < 0.001). However, NAFLD was not related to CKD with an odds ratio (OR) of 1.015 (95% confidence interval [CI] 0.954-1.081, p = 0.630) after multivariate analyses. Nevertheless, further analyses revealed that among patients with NAFLD, those with advanced fibrosis were more likely to have CKD after adjusting for confounding factors (OR 2.284, 95% CI 1.513-3.448, p < 0.001).
CONCLUSION
NAFLD per se was not a risk factor for CKD, but NAFLD patients with advanced fibrosis faced a higher possibility of CKD. Hence, patients with NAFLD and advanced fibrosis should be screened for CKD and prompted to receive treatment if the diagnosis was made.
背景/目的：非酒精性脂肪性肝病（NAFLD）对慢性肾脏病（CKD）患病率的影响尚未完全阐明。本研究旨在一项大型人群研究中评估 NAFLD 与 CKD 之间的相关性。
方法
我们纳入了 2002 年至 2009 年在台北荣民总医院接受健康检查服务的连续患者。通过腹部超声诊断 NAFLD，并用 NAFLD 纤维化评分（NAFLD-FS）确定晚期肝纤维化。CKD 定义为估计肾小球滤过率（eGFR）<60 mL/min/1.73 m。
结果
在本研究纳入的 29797 名患者中，分别有 44.5%和 20.2%的患者诊断为 NAFLD 和 CKD。与无 NAFLD 的患者相比，有 NAFLD 的患者更易患有 CKD（24.1% vs. 17.1%，p<0.001）。然而，经过多变量分析，NAFLD 与 CKD 无关，比值比（OR）为 1.015（95%置信区间 [CI] 0.954-1.081，p=0.630）。然而，进一步分析表明，在患有 NAFLD 的患者中，在调整混杂因素后，纤维化程度较高的患者更有可能患有 CKD（OR 2.284，95% CI 1.513-3.448，p<0.001）。
结论
NAFLD 本身不是 CKD 的危险因素，但纤维化程度较高的 NAFLD 患者患 CKD 的可能性更高。因此，患有 NAFLD 和晚期纤维化的患者应进行 CKD 的筛查，如果确诊应及时接受治疗。
Zotero 插件