Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC.
Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
J Formos Med Assoc. 2020 Jan;119(1 Pt 3):496-503. doi: 10.1016/j.jfma.2019.07.007. Epub 2019 Jul 25.
BACKGROUND/PURPOSE: Chronic kidney disease (CKD) has become a worldwide health problem, leading to high morbidity and mortality, and non-alcoholic fatty liver disease (NAFLD) is considered a risk factor for CKD. The aim of this study was to explore the relationship between NAFLD fibrosis score (NFS) and the estimated glomerular filtration rate (eGFR), and identify possible risk factors related to the NFS among Taiwanese subjects.
Subjects were enrolled from the database of the Department of Preventive Medicine of Kaohsiung Municipal Hsiao-Kang Hospital. The eGFR was calculated according to the Taiwanese Modification of Diet in Renal Disease (TMDRD) equation, and the NFS was employed to evaluate the fibrotic level.
In total, 11,376 subjects were enrolled in this study, with a mean age of 52.0 ± 6.81 years, including 4529 (39.8%) males. A fasting sugar level ≥100 mg/dL (OR = 1.70, 95% CI = 1.52-1.87) and an abnormal waist circumference (OR = 1.81, 95% CI = 1.65-1.99) were significant factors associated with NFS (p < 0.05). Trends of a decreasing TMDRD score and an increasing NFS with increasing age were noted (p < 0.05). The NFS was significantly negatively correlated with the TMDRD score (standard coefficients: -0.067, p < 0.001).
A higher NFS is associated with an impaired eGFR in Taiwanese subjects. Controlling risk factors, especially fasting sugar level and waist circumference, may be useful in preventing NFS deterioration, which is negatively correlated with the eGFR.
背景/目的：慢性肾脏病（CKD）已成为全球性的健康问题，导致高发病率和死亡率，非酒精性脂肪性肝病（NAFLD）被认为是 CKD 的一个危险因素。本研究旨在探讨 NAFLD 纤维化评分（NFS）与估算肾小球滤过率（eGFR）之间的关系，并确定台湾人群中与 NFS 相关的可能危险因素。
本研究从高雄小港医院预防医学科的数据库中招募了受试者。根据台湾改良肾脏病饮食法（TMDRD）方程计算 eGFR，并用 NFS 评估纤维化程度。
本研究共纳入了 11376 名受试者，平均年龄为 52.0±6.81 岁，其中 4529 名（39.8%）为男性。空腹血糖水平≥100mg/dL（OR=1.70，95%CI=1.52-1.87）和腰围异常（OR=1.81，95%CI=1.65-1.99）是与 NFS 相关的显著因素（p<0.05）。随着年龄的增长，TMDRD 评分下降和 NFS 增加的趋势明显（p<0.05）。NFS 与 TMDRD 评分显著负相关（标准系数：-0.067，p<0.001）。
在台湾人群中，较高的 NFS 与 eGFR 受损有关。控制危险因素，特别是空腹血糖水平和腰围，可能有助于防止 NFS 恶化，而 NFS 与 eGFR 呈负相关。
