Wei Suosu, Song Jian, Xie Yujie, Huang Junzhang, Yang Jianrong
Department of Scientific Cooperation of Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Institute of Cardiovascular Diseases of Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
Diabetes Res Clin Pract. 2023 Mar;197:110563. doi: 10.1016/j.diabres.2023.110563. Epub 2023 Feb 2.
This study is to explore the relationship between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD) among populations with type 2 diabetes through longitudinal cohort study.
3,627 subjects who had received at least three health examinations between 2008 and 2015 were included. CKD was stated as subjects with an eGFR < 60 mL/min per 1·73 m2 or the occurrence of 2 or more proteinuria during their follow-up.
After median of 10·0 years follow up, 837 (23·1%) developed CKD (244·7 per 10,000 person-years; 95 % CI, 228.4 - 261·8). MAFLD ([HR] 1·46; 95 % CI 1·26-1·70, P < 0.001) acts as an important risk factor of developing CKD. After adjusting for confounding factors, this association was consistent (HR 1·30; 95 % CI 1·11-1·53, P < 0.001). In stratified analysis, subjects aged < 60 years were likely to have greater risk of MAFLD-related CKD (HR 1·58 and 1·03; 95 % CI 1·28-1·95 and 0·79-1·33, P < 0.001 in both cases, respectively).
The risk of developing CKD in type 2 diabetes adults with MAFLD was higher, especially if they are below 60 years old. This study underscores the importance of early prevention strategies for MAFLD to reduce the occurrence of CKD in type 2 diabetes adults.
本研究旨在通过纵向队列研究，探讨2型糖尿病患者中代谢功能障碍相关脂肪性肝病（MAFLD）与慢性肾脏病（CKD）之间的关系。
纳入2008年至2015年间接受至少三次健康检查的3627名受试者。CKD定义为估算肾小球滤过率（eGFR）<60 mL/（min·1.73 m²）或随访期间出现2次及以上蛋白尿的受试者。
经过中位10.0年的随访，837名（23.1%）受试者发生了CKD（每10000人年244.·7例；95%CI，228.4 - 261.8）。MAFLD（风险比[HR]为1.46；95%CI为1.26 - 1.70，P < 0.001）是发生CKD的重要危险因素。在调整混杂因素后，这种关联仍然一致（HR为1.30；95%CI为1.11 - 1.53, P < 0.001）。分层分析显示，年龄<60岁的受试者发生MAFLD相关CKD的风险可能更高（HR分别为1.58和1.03；95%CI分别为1.28 - 1.95和0.79 - 1.33，两种情况P均< 0.001）。
患有MAFLD的2型糖尿病成年患者发生CKD的风险更高，尤其是年龄在60岁以下者。本研究强调了针对MAFLD采取早期预防策略以降低2型糖尿病成年患者CKD发生率的重要性。
