Lee Sung-Bum, Park Byoung-Jin, Lee Yong-Jae, Jung Dong-Hyuk
Department of Health Check-up, Yongin Severance Hospital, Yongin-si 16995, Korea.
Department of Family Medicine, Yongin Severance Hospital, Yongin-si 16995, Korea.
Biomedicines. 2021 Sep 29;9(10):1358. doi: 10.3390/biomedicines9101358.
Hepatic steatosis and chronic kidney disease (CKD) in the advanced stages are closely related to cardiovascular diseases. Despite the potential connection between early CKD (G1-G3a) and hepatic steatosis on cardiometabolic risks, few studies have revealed their causal link to ischemic heart disease (IHD). We prospectively investigated the combined effect of CKD in earlier stages and hepatic steatosis on incident IHD risk in large-scale, non-diabetic Koreans. Data were assessed from 16,531 participants without diabetes from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. We divided the study population into four groups according to the existence of early CKD and hepatic steatosis: controls, early CKD only, hepatic steatosis only, and both early CKD and hepatic steatosis. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazard regression models over a 50-month period. During the follow-up period, 326 (2.0%) patients developed IHD. HRs of IHD in the four groups were 1.00 (controls), 1.26 (95% CI 0.72-2.19), 1.19 (95% CI 0.90-1.57) and 1.76 (95% CI 1.04-2.97), respectively, after adjusting for potential confounding variables. Even less than stage 3A, CKD could precede and predict IHD in patients with hepatic steatosis.
晚期肝脂肪变性和慢性肾脏病（CKD）与心血管疾病密切相关。尽管早期CKD（G1-G3a）与肝脂肪变性在心脏代谢风险方面存在潜在联系，但很少有研究揭示它们与缺血性心脏病（IHD）之间的因果关系。我们对大量非糖尿病韩国人群中早期CKD和肝脂肪变性对IHD发病风险的联合影响进行了前瞻性研究。数据来自健康风险评估研究（HERAS）和韩国健康保险审查与评估（HIRA）中16531名无糖尿病的参与者。我们根据早期CKD和肝脂肪变性的存在情况将研究人群分为四组：对照组、仅早期CKD组、仅肝脂肪变性组以及早期CKD和肝脂肪变性均有的组。我们使用多变量Cox比例风险回归模型在50个月的时间内前瞻性评估IHD的风险比（HRs）及95%置信区间（CIs）。在随访期间，326名（2.0%）患者发生了IHD。在调整潜在混杂变量后，四组IHD的HRs分别为1.00（对照组）、1.26（95%CI 0.72-2.19）、1.19（95%CI 0.90-1.57）和1.76（95%CI 1.04-2.97）。即使在3A期以下，CKD也可能先于并预测肝脂肪变性患者发生IHD。
