Association between non-alcoholic fatty liver disease and chronic kidney disease in population with prediabetes or diabetes

Li, Yongqiang; Zhu, Shuangshuang; Li, Bin; Shao, Xiaofei; Liu, Xinyu; Liu, Aiqun; Wu, Bifang; Zhang, Ying; Wang, Honglei; Wang, Xiaohong; Deng, Kangping; Q, Liu; Huang, Minyi; Liu, Hongmei; Holthöfer, Harry; Zou, Hequn

doi:10.1007/s11255-014-0796-9

Cited by 29 publications

(29 citation statements)

References 31 publications

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“…In particular, numerous observational studies showed that NAFLD is associated with an increased prevalence of CKD (defined as estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m 2 or proteinuria) both in patients without diabetes and in those with T2DM or T1DM 89 . As shown in Some other studies in which NAFLD was diagnosed by either ultrasonography or histology have shown that the presence and severity of NAFLD was strongly associated with an increased prevalence of abnormal albuminuria or decreased kidney function in patients with T2DM or prediabetes 89, 92,93 . Similarly, some smaller cohorts of Italian adult outpatients with T1DM have shown that ultrasound-diagnosed NAFLD was associated with the presence of diabetic retinopathy or nephropathy, independently of age, sex, BMI, hypertension, diabetes duration, haemoglobin A1c and use of medications 94,95 .…”

Section: Microvascular Complicationsmentioning

confidence: 67%

Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus

2017

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Nonalcoholic fatty liver disease (NAFLD) and diabetes mellitus are common diseases that often coexist and might act synergistically to increase the risk of hepatic and extra-hepatic clinical outcomes. NAFLD affects up to 70-80% of patients with type 2 diabetes mellitus and up to 30-40% of adults with type 1 diabetes mellitus. The coexistence of NAFLD and diabetes mellitus increases the risk of developing not only the more severe forms of NAFLD but also chronic vascular complications of diabetes mellitus. Indeed, substantial evidence links NAFLD with an increased risk of developing cardiovascular disease and other cardiac and arrhythmic complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus. NAFLD is also associated with an increased risk of developing microvascular diabetic complications, especially chronic kidney disease. This Review focuses on the strong association between NAFLD and the risk of chronic vascular complications in patients with type 1 diabetes mellitus or type 2 diabetes mellitus, thereby promoting an increased awareness of the extra-hepatic implications of this increasingly prevalent and burdensome liver disease. We also discuss the putative underlying mechanisms by which NAFLD contributes to vascular diseases, as well as the emerging role of changes in the gut microbiota (dysbiosis) in the pathogenesis of NAFLD and associated vascular diseases.

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Section: Microvascular Complicationsmentioning

confidence: 67%

Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus

2017

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“…Our findings regarding NAFLD and CKD are consistent with those of previous studies. 6,7 Targher et al reported that patients with diabetes and NAFLD had higher rates of diabetic nephropathy. 6 In addition, Hwang et al reported a close association between microalbuminuria and NAFLD in prediabetic patients and in those with newly diagnosed diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…3 NAFLD has increasingly been reported to be a common cause of chronic liver disease, and to be associated with both liver-related morbidity and mortality 4 and increased risks of developing cardiovascular disease (CVD) and adverse CVD outcomes. 5 An increasing number of epidemiologic studies have reported an association between NAFLD and CKD, especially in people with T2DM, 6,7 and there has also been increased focus on NAFLD-related CKD. 8 Diverse and complex factors have been associated with the development and progression of CKD and NAFLD.…”

Section: Introductionmentioning

confidence: 99%

<p>Common and Unique Factors and the Bidirectional Relationship Between Chronic Kidney Disease and Nonalcoholic Fatty Liver in Type 2 Diabetes Patients</p>

Lee

Wang²,

Hung³

et al. 2020

DMSO

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This study aimed to investigate the common and unique risk factors and bidirectional relationship between chronic kidney disease (CKD) and nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Patients and Methods: This was a cross-sectional study of patients with T2DM enrolled in a disease management program at two specialized diabetes outpatient clinics. Common and unique risk factors for CKD and NAFLD were examined using structural equation models (SEMs). SEMs were also used to examine direct and indirect effects of NAFLD on CKD and those of CKD on NAFLD. Results: A total of 1992 subjects with T2DM were enrolled in this study. In multivariate analysis, NAFLD was independently associated with the odds of CKD (adjusted odds ratio=1.59, 95% confidence interval=1.12-2.25, P=0.009). SEMs showed that age, triglyceride, uric acid (UA), albumin, and HbA1c levels had statistically significant direct effects on CKD, and the final model could explain 22% of the variability in CKD. Age, triglycerides, body mass index (BMI), UA, white blood cell (WBC) count, serum glutamic pyruvic transaminase (SGPT) level, and smoking status had statistically significant direct effects on NAFLD, and the final model could explain 43% of the variability in NAFLD. The common risk factors contributing to both CKD and NAFLD were age, triglycerides, and UA. The unique risk factors were albumin and HbA1c for CKD, and BMI, WBC, SGPT, and smoking for NAFLD. In addition, SEM analysis also confirmed the bidirectional causal relationship between NAFLD and CKD. Conclusion: Common and unique risk factors and a bidirectional relationship existed between CKD and NAFLD in our patients with T2DM.

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“…It is now accepted that NAFLD and NASH are associated with CKD independent of other risk factors such as age, sex, BMI, hypertension, diabetes, smoking, and hyperlipidemia (Armstrong et al, 2014; Fabrizi et al, 2013; Hamad et al, 2012; Y. Li et al, 2014; Mikolasevic et al, 2013; Targher et al, 2010, 2011; Yasui et al, 2011; Yilmaz et al, 2010).…”

Section: Nash As Another Factor In Precision Medicinementioning

confidence: 99%

Nonalcoholic steatohepatitis in precision medicine: Unraveling the factors that contribute to individual variability

Clarke

Cherrington

2015

Pharmacology & Therapeutics

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There are numerous factors in individual variability that make the development and implementation of precision medicine a challenge in the clinic. One of the main goals of precision medicine is to identify the correct dose for each individual in order to maximize therapeutic effect and minimize the occurrence of adverse drug reactions. Many promising advances have been made in identifying and understanding how factors such as genetic polymorphisms can influence drug pharmacokinetics (PK) and contribute to variable drug response (VDR), but it is clear that there remain many unidentified variables. Underlying liver diseases such as nonalcoholic steatohepatitis (NASH) alter absorption, distribution, metabolism, and excretion (ADME) processes and must be considered in the implementation of precision medicine. There is still a profound need for clinical investigation into how NASH-associated changes in ADME mediators, such as metabolism enzymes and transporters, affect the pharmacokinetics of individual drugs known to rely on these pathways for elimination. This review summarizes the key PK factors in individual variability and VDR and highlights NASH as an essential underlying factor that must be considered as the development of precision medicine advances. A multifactorial approach to precision medicine that considers the combination of two or more risk factors (e.g. genetics and NASH) will be required in our effort to provide a new era of benefit for patients.

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Association between non-alcoholic fatty liver disease and chronic kidney disease in population with prediabetes or diabetes

Abstract: Our current study suggests that ultrasound-diagnosed NAFLD is associated with CKD among population with prediabetes or diabetes.

Cited by 29 publications

References 31 publications

Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus

Nonalcoholic fatty liver disease and chronic vascular complications of diabetes mellitus

<p>Common and Unique Factors and the Bidirectional Relationship Between Chronic Kidney Disease and Nonalcoholic Fatty Liver in Type 2 Diabetes Patients</p>

Nonalcoholic steatohepatitis in precision medicine: Unraveling the factors that contribute to individual variability

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