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代谢相关脂肪性肝病是慢性肾脏病的一个危险因素。

Metabolic associated fatty liver disease is a risk factor for chronic kidney disease.

机构信息

Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Gastroenterology, Asahi University Hospital, Gifu, Japan.

出版信息

J Diabetes Investig. 2022 Feb;13(2):308-316. doi: 10.1111/jdi.13678. Epub 2021 Oct 12.

Abstract

BACKGROUND AND AIMS

To clarify the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD).

METHODS

The participants were divided into four groups by the presence or absence of fatty liver disease (FLD) and metabolic dysfunction (MD). MAFLD was defined as having both FLD and MD, whereas CKD was defined as having an estimated glomerular filtration rate of <60 mL/min/1.73 m and/or proteinuria.

RESULTS

In this cross-sectional study of 27,371 participants, the proportions of those in the non-FLD without MD, non-FLD with MD, FLD without MD, and MAFLD groups were 48.7, 28.2, 2.3, and 20.8%, respectively. Compared with non-FLD without MD, MAFLD was associated with the risk of CKD (adjusted odds ratio 1.83 [1.66-2.01], P < 0.001), whereas FLD without MD was not (1.02 [0.79-1.33], P = 0.868). Moreover, compared with FLD without MD, MAFLD was associated with the risk of CKD (1.19 [1.09-1.31], P < 0.001). In this retrospective cohort study, 16,938 of 27,371 participants underwent a median 4.6 (2.0-8.1) years follow-up, and incident data of non-FLD without MD, non-FLD with MD, FLD without MD, and MAFLD were 21.0, 31.1, 26.1, and 31.1 cases per 1,000 person-years, respectively. Compared with the non-FLD without MD, MAFLD was associated with the risk of incident CKD (adjusted hazard ratio 1.24 [1.14-1.36], P < 0.001), whereas FLD without MD was not (1.11 [0.85-1.41], P = 0.433).

CONCLUSIONS

MAFLD was associated with a risk of CKD, whereas FLD without MD was not a risk for CKD.

摘要

背景与目的

明确代谢相关脂肪性肝病(MAFLD)与慢性肾脏病(CKD)之间的关系。

方法

根据是否存在脂肪肝(FLD)和代谢功能障碍(MD)将参与者分为四组。MAFLD 定义为同时存在 FLD 和 MD,而 CKD 定义为估计肾小球滤过率 <60ml/min/1.73m2 和/或蛋白尿。

结果

在这项纳入 27371 名参与者的横断面研究中,无 FLD 且无 MD、无 FLD 但有 MD、有 FLD 但无 MD 和 MAFLD 组的比例分别为 48.7%、28.2%、2.3%和 20.8%。与无 FLD 且无 MD 相比,MAFLD 与 CKD 风险相关(校正优势比 1.83[1.66-2.01],P<0.001),而无 FLD 但有 MD 则不然(1.02[0.79-1.33],P=0.868)。此外,与无 FLD 但有 MD 相比,MAFLD 与 CKD 风险相关(1.19[1.09-1.31],P<0.001)。在这项回顾性队列研究中,27371 名参与者中有 16938 名接受了中位数为 4.6(2.0-8.1)年的随访,无 FLD 且无 MD、无 FLD 但有 MD、有 FLD 但无 MD 和 MAFLD 的非 CKD 发生率分别为 21.0、31.1、26.1 和 31.1 例/1000 人年。与无 FLD 且无 MD 相比,MAFLD 与 CKD 发病风险相关(校正风险比 1.24[1.14-1.36],P<0.001),而无 FLD 但有 MD 则不然(1.11[0.85-1.41],P=0.433)。

结论

MAFLD 与 CKD 风险相关,而无 FLD 但有 MD 不是 CKD 的风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76a1/8847128/42d35946bf47/JDI-13-308-g002.jpg

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