Xiong Shengjun, Wang Pengbo, Yin Shizhang, Deng Wanshu, Zhao Yuanhui, Li Wenhang, Li Zhao, Zhou Ying, Yu Shasha, Yang Hongmei, Guo Xiaofan, Sun Yingxian
Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China.
Front Med (Lausanne). 2023 Jan 30;10:1046825. doi: 10.3389/fmed.2023.1046825. eCollection 2023.
This study aimed to clarify the relationship between liver fibrosis scores (Fibrosis-4, BARD score, and BAAT score) and chronic kidney disease (CKD).
We collected a range of data from 11,503 subjects (5,326 men and 6,177 women) from the rural regions of Northeastern China. Three liver fibrosis scores (LFSs) including fibrosis-4 (FIB-4), BARD score, and BAAT score were adopted. A logistic regression analysis was used to calculate odds ratios and the 95% confidence interval. A subgroup analysis showed the association between LFSs and CKD under different stratifications. Restricted cubic spline could further explore whether there is a linear relationship between LFSs and CKD. Finally, we used C-statistics, Net Reclassification Index (NRI), and Integrated Discrimination Improvement (IDI) to assess the effect of each LFS on CKD.
Through the baseline characteristics, we observed that LFSs were higher in the CKD population than in non-CKD. The proportion of participants with CKD also increased with LFSs. In a multivariate logistic regression analysis, the ORs of CKD were 6.71 (4.45-10.13) in FIB-4, 1.88 (1.29-2.75) in the BAAT score, and 1.72 (1.28-2.31) in the BARD score by comparing the high level with the low level in each LFSs. Moreover, after adding LFSs to the original risk prediction model, which consisted of age, sex, drinking, smoking, diabetes, low-density lipoprotein cholesterol, total cholesterol, triglycerides, and mean waist circumference, we found the new models have higher C-statistics. Furthermore, NRI and IDI both indicate LFSs had a positive effect on the model.
Our study showed that LFSs are associated with CKD among middle-aged populations in rural areas of northeastern China.
本研究旨在阐明肝纤维化评分（Fibrosis-4、BARD评分和BAAT评分）与慢性肾脏病（CKD）之间的关系。
我们收集了来自中国东北农村地区11503名受试者（5326名男性和6177名女性）的一系列数据。采用了三种肝纤维化评分（LFSs），包括Fibrosis-4（FIB-4）、BARD评分和BAAT评分。使用逻辑回归分析来计算比值比和95%置信区间。亚组分析显示了不同分层下LFSs与CKD之间的关联。限制立方样条可以进一步探索LFSs与CKD之间是否存在线性关系。最后，我们使用C统计量、净重新分类指数（NRI）和综合判别改善（IDI）来评估每个LFS对CKD的影响。
通过基线特征，我们观察到CKD人群中的LFSs高于非CKD人群。CKD参与者的比例也随着LFSs的增加而增加。在多变量逻辑回归分析中，通过比较每个LFSs中的高水平与低水平，FIB-4中CKD的OR为6.71（4.45-10.13），BAAT评分中为1.88（1.29-2.75），BARD评分中为1.72（1.28-2.31）。此外，在将LFSs添加到由年龄、性别、饮酒、吸烟、糖尿病、低密度脂蛋白胆固醇、总胆固醇、甘油三酯和平均腰围组成的原始风险预测模型后，我们发现新模型具有更高的C统计量。此外，NRI和IDI均表明LFSs对模型有积极影响。
我们的研究表明，在中国东北农村地区的中年人群中，LFSs与CKD相关。
