Department of Gastroenterology, Union Hospital of Fujian Medical University, Fuzhou, Fujian.
Liver Research Center of the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, 350000, China.
Clin Res Hepatol Gastroenterol. 2021 Mar;45(2):101483. doi: 10.1016/j.clinre.2020.06.009. Epub 2020 Jul 6.
Coexistence of non-alcoholic fatty liver disease (NAFLD) and hepatitis B virus (HBV) infection is common in clinical practice. This study was to explore the prevalence of chronic kidney disease (CKD) in patients with NAFLD and/or HBV.
Participants who received health examination in a physical examination center were included in this cross-sectional study. Binary logistic regression was used to estimate the odds ratios (ORs) for CKD.
A total of 32,578 cases were included in the final analysis, with 52.3% males and an average age of 44.01±13.09 years old. The positive rate of HBV surface antigen was 14.5% and NAFLD was diagnosed in 30.2% cases. The coexistence of NAFLD and HBV-infection was found in 1,275 (3.9%) cases. In overall population, 713 (2.2%) cases were diagnosed with CKD. The CKD prevalence were 1.4%, 2.1%, 3.5% and 5.0% in those without NAFLD or HBV, HBV-infection alone, NAFLD alone and those with concomitant HBV-infection and NAFLD, respectively. After adjustment for age, sex, body mass index, diabetes and hypertension, the correlation between CKD and liver disease was still significant in HBV group (OR=1.388, 95%CI: 1.055-1.809), yet no longer existed in patients with NAFLD (OR=1.183, 95%CI: 0.986-1.420). The concomitant of NAFLD and HBV infection was associated with a higher odds ratio for CKD compared to any other group (OR=1.961, 95%CI=1.454-2.645).
The coexistence of NAFLD and HBV increases the risk of CKD by 2-fold. The control of multiple liver diseases will be beneficial not only to liver but also to kidney.
非酒精性脂肪性肝病（NAFLD）和乙型肝炎病毒（HBV）感染共存于临床实践中较为常见。本研究旨在探讨 NAFLD 和/或 HBV 患者中慢性肾脏病（CKD）的患病率。
本横断面研究纳入了在体检中心接受体检的参与者。采用二项逻辑回归估计 CKD 的比值比（OR）。
共有 32578 例患者纳入最终分析，其中男性占 52.3%，平均年龄为 44.01±13.09 岁。HBV 表面抗原阳性率为 14.5%，NAFLD 诊断率为 30.2%。1275 例（3.9%）患者同时存在 NAFLD 和 HBV 感染。在总体人群中，713 例（2.2%）患者被诊断为 CKD。无 NAFLD 或 HBV、HBV 感染单独、NAFLD 单独和同时存在 HBV 感染和 NAFLD 的患者中，CKD 的患病率分别为 1.4%、2.1%、3.5%和 5.0%。在校正年龄、性别、体重指数、糖尿病和高血压后，HBV 组中 CKD 与肝病之间的相关性仍然显著（OR=1.388，95%CI：1.055-1.809），而在 NAFLD 患者中则不存在（OR=1.183，95%CI：0.986-1.420）。与其他任何组相比，NAFLD 和 HBV 感染的共存与 CKD 的更高比值比相关（OR=1.961，95%CI=1.454-2.645）。
NAFLD 和 HBV 的共存使 CKD 的风险增加 2 倍。控制多种肝病不仅对肝脏有益，对肾脏也有益。
