You Yixian, Pei Xiong, Jiang Wei, Zeng Qingmin, Bai Lang, Zhou Taoyou, Lv Xiaoju, Tang Hong, Wu Dongbo
Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
PeerJ. 2024 Dec 17;12:e18459. doi: 10.7717/peerj.18459. eCollection 2024.
Data on risk of developing chronic kidney disease (CKD) between non-obese and obese non-alcoholic fatty liver disease (NAFLD) patients are limited. We aimed to reveal the risk difference of incident CKD between non-obese and obese NAFLD patients.
We searched PubMed, Embase, and Web of Science databases for studies which reported the incidence of CKD in non-obese and obese NAFLD from inception to 10 March 2024. The primary and secondary outcomes were pooled. Subgroup analysis was used to examine the heterogeneity.
A total of 15 studies were incorporated. The incidence of CKD in non-obese and obese NAFLD were 1,450/38,720 (3.74%) and 3,067/84,154 (3.64%), respectively. Non-obese NAFLD patients had a comparable risk of CKD as obese NAFLD (odds ratio [OR] 0.92, 95% confidence interval [95% CI] [0.72-1.19], I = 88%). No differences in estimated glomerular filtration rate and serum creatinine between non-obese and obese NAFLD were found. The mean differences (MD) and 95% CI were 0.01 [-0.02 to 0.04] and 0.50 [-0.90 to 1.90], respectively. In subgroup analyses, non-obese NAFLD had higher eGFR when diagnosed with ultrasound (MD 1.45, 95% CI [0.11-2.79], I = 21%). Non-obese NAFLD had higher creatinine in non-Asian (MD 0.06, 95% CI [0.01-0.11], I = 55%) and when taking BMI > 30 as the criterion for obesity (MD 0.06, 95% CI [0.00-0.12], I = 76%). The occurrence of CKD did not differ when non-obese NAFLD were categorized into overweight and normal-weight types.
Non-obese NAFLD patients experienced the same risk of CKD compared to obese NAFLD.
非肥胖和肥胖非酒精性脂肪性肝病（NAFLD）患者发生慢性肾脏病（CKD）风险的数据有限。我们旨在揭示非肥胖和肥胖NAFLD患者发生CKD的风险差异。
我们检索了PubMed、Embase和Web of Science数据库，查找从开始到2024年3月10日期间报告非肥胖和肥胖NAFLD患者CKD发病率的研究。汇总主要和次要结局。采用亚组分析来检验异质性。
共纳入15项研究。非肥胖和肥胖NAFLD患者的CKD发病率分别为1450/38720（3.74%）和3067/84154（3.64%）。非肥胖NAFLD患者发生CKD的风险与肥胖NAFLD患者相当（优势比[OR]0.92，95%置信区间[95%CI][0.72 - 1.19]，I² = 88%）。未发现非肥胖和肥胖NAFLD患者在估计肾小球滤过率和血清肌酐方面存在差异。平均差异（MD）和95%CI分别为0.01[-0.02至0.04]和0.50[-0.90至1.90]。在亚组分析中，通过超声诊断时非肥胖NAFLD患者的估算肾小球滤过率较高（MD 1.45，95%CI[0.11 - 2.79]，I² = 21%）。在非亚洲人群中以及以BMI>30作为肥胖标准时，非肥胖NAFLD患者的肌酐水平较高（MD 0.06，95%CI[0.01 - 0.11]，I² = 55%；MD 0.06，95%CI[0.00 - 0.12]，I² = 76%）。当将非肥胖NAFLD分为超重和正常体重类型时，CKD的发生率没有差异。
与肥胖NAFLD患者相比，非肥胖NAFLD患者发生CKD的风险相同。
