代谢相关脂肪性肝病与慢性肾脏病的相关性：一项基于中国人群的研究。
Association of metabolic dysfunction-associated fatty liver disease with chronic kidney disease: a Chinese population-based study.
机构信息
Health Management Center, West China Hospital of Sichuan University, Chengdu, China.
Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China.
出版信息
Ren Fail. 2022 Dec;44(1):1996-2005. doi: 10.1080/0886022X.2022.2144373.
BACKGROUND
Metabolic dysfunction-associated fatty liver disease (MAFLD) is a multisystem disorder, but its relationship with kidney injury remains controversial. This study aimed to evaluate MAFLD effects on the chronic kidney disease (CKD) prevalence in a general population in China.
METHODS
In total, 15,010 individuals from the Health Management Center of West China Hospital from July 2020 to June 2021 were screened. Hepatic steatosis was defined as a median FibroScan controlled attenuation parameter (CAP)≥240 dB/m using liver ultrasound transient elastography. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m and/or the presence of albuminuria. The association of MAFLD with CKD was examined using logistic regression. Risk factors for CKD in different MAFLD subgroups were also investigated.
RESULTS
A total of 8226 individuals were finally included. Of them, 4406 (53.6%) had MAFLD, and 592 (7.2%) had CKD. After propensity score matching (PSM), 5530 eligible subjects were selected ( = 2765 in each group). There was a higher CKD prevalence in subjects with MAFLD than in those without MAFLD (8.9% vs. 5.4%, < 0.001). MAFLD was significantly associated with a higher CKD prevalence (OR 1.715, 95% CI 1.389-2.117, < 0.001), although it was not an independent risk factor. The results indicated that age, diabetes mellitus (DM), overweight/obesity, hypertension, hyperuricemia, hypertriglyceridemia, remnant cholesterol (RC), and C-reactive protein (CRP) were independently associated with a higher CKD prevalence. In the subgroup analysis, hypertension, hyperuricemia, RC, and the nonalcoholic fatty liver disease fibrosis score (NFS) were independent risk factors for the prevalence of CKD in individuals with DM or prediabetes and MAFLD. Furthermore, hypertension, hyperuricemia, and body fat percentage (BFP) were independently associated with CKD in subjects with MAFLD without DM.
CONCLUSION
Individuals with MAFLD had a higher prevalence of CKD, whereas it was not an independent risk factor for CKD.
背景
代谢相关脂肪性肝病（MAFLD）是一种多系统疾病，但它与肾脏损伤的关系仍存在争议。本研究旨在评估 MAFLD 对中国一般人群慢性肾脏病（CKD）患病率的影响。
方法
2020 年 7 月至 2021 年 6 月，我们从华西医院健康管理中心筛选了 15010 名个体。肝超声瞬时弹性成像检测肝脂肪变定义为 FibroScan 受控衰减参数（CAP）中位数≥240dB/m。CKD 定义为估算肾小球滤过率（eGFR）<60mL/min/1.73m2 和/或白蛋白尿。使用逻辑回归检查 MAFLD 与 CKD 的相关性。还研究了不同 MAFLD 亚组中 CKD 的危险因素。
结果
共纳入 8226 名个体，其中 4406 名（53.6%）患有 MAFLD，592 名（7.2%）患有 CKD。经过倾向评分匹配（PSM）后，选择了 5530 名合格受试者（每组 2765 名）。MAFLD 组的 CKD 患病率高于无 MAFLD 组（8.9% vs. 5.4%，<0.001）。MAFLD 与较高的 CKD 患病率显著相关（OR 1.715，95%CI 1.389-2.117，<0.001），尽管它不是独立的危险因素。结果表明，年龄、糖尿病（DM）、超重/肥胖、高血压、高尿酸血症、高三酰甘油血症、残余胆固醇（RC）和 C 反应蛋白（CRP）是 CKD 患病率较高的独立危险因素。在亚组分析中，高血压、高尿酸血症、RC 和非酒精性脂肪性肝病纤维化评分（NFS）是合并或不合并 DM 的 MAFLD 患者 CKD 患病率的独立危险因素。此外，高血压、高尿酸血症和体脂百分比（BFP）是 MAFLD 患者中与 CKD 相关的独立因素，无论是否合并 DM。
结论
患有 MAFLD 的个体 CKD 患病率较高，但不是 CKD 的独立危险因素。
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