Department of Ultrasound, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Obes Facts. 2023;16(6):548-558. doi: 10.1159/000533626. Epub 2023 Aug 28.
The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) with renal insufficiency in recent years and the association between MAFLD and renal insufficiency are not entirely clear, especially in overweight/obesity. The aim of this study was to analyze the prevalence and risk factors of MAFLD with renal insufficiency in overweight/obese adults.
Individuals who attended checkup at the Second Affiliated Hospital of Xi'an Jiaotong University from 2016 to 2021 were included. The prevalence of MAFLD with renal insufficiency (estimated glomerular filtration rate ≤90 mL/min/1.73 m2) in overweight/obesity was estimated. Propensity score-matched analysis, univariate and multivariate analyses were used to determine the risk factors for MAFLD with renal insufficiency.
From 2016 to 2021, the prevalence of MAFLD in overweight/obesity reached its highest of 44.7% in 2017 and its lowest of 36.9% in 2018; and 33.9% in 2021 and 21.8% in 2019 is the highest and lowest prevalence of MAFLD with renal insufficiency, respectively. MAFLD was more common in men, old individuals, and persons with a higher body mass index (BMI) and was characterized by significant renal insufficiency. MAFLD with renal insufficiency was more common in women, old individuals, and persons with a higher BMI and was characterized by significant metabolic dysfunction and liver fibrosis. Multivariable analysis showed that BMI, uric acid, and fibrosis (evaluated with noninvasive liver fibrosis score [fibrosis-4]) were independent risk factors for MAFLD with renal insufficiency.
The prevalence of MAFLD with renal insufficiency in overweight/obese adults is quite high in the last 5 years. BMI, uric acid, and fibrosis are independent risk factors for MAFLD with renal insufficiency.
近年来,代谢相关脂肪性肝病(MAFLD)伴肾功能不全的患病率以及 MAFLD 与肾功能不全之间的关系尚不完全清楚,尤其是在超重/肥胖人群中。本研究旨在分析超重/肥胖成年人中 MAFLD 伴肾功能不全的患病率及相关危险因素。
本研究纳入了 2016 年至 2021 年在西安交通大学第二附属医院体检的人群。评估了超重/肥胖人群中 MAFLD 伴肾功能不全(估算肾小球滤过率≤90ml/min/1.73m2)的患病率。采用倾向评分匹配分析、单因素和多因素分析来确定 MAFLD 伴肾功能不全的危险因素。
2016 年至 2021 年,超重/肥胖人群中 MAFLD 的患病率在 2017 年达到最高的 44.7%,在 2018 年达到最低的 36.9%;2021 年和 2019 年 MAFLD 伴肾功能不全的患病率最高和最低分别为 33.9%和 21.8%。MAFLD 更常见于男性、老年人和 BMI 较高的人群,且伴有显著的肾功能不全。MAFLD 伴肾功能不全更常见于女性、老年人和 BMI 较高的人群,且伴有显著的代谢功能障碍和肝纤维化。多因素分析显示,BMI、尿酸和纤维化(采用无创性肝纤维化评分[fibrosis-4]评估)是 MAFLD 伴肾功能不全的独立危险因素。
在过去 5 年中,超重/肥胖成年人中 MAFLD 伴肾功能不全的患病率相当高。BMI、尿酸和纤维化是 MAFLD 伴肾功能不全的独立危险因素。