Association between non‐invasively diagnosed hepatic steatosis and chronic kidney disease in <scp>C</scp>hinese adults on their health check‐up

Zeng, Jing; Sun, Chao; Sun, Wan Lu; Chen, Guang Yu; Pan, Qin; Shi, Yan; Xu, Zheng; Chen, Yuan Wen; Fan, Jian Gao

doi:10.1111/1751-2980.12465

Cited by 15 publications

(12 citation statements)

References 29 publications

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“…Consistent with our findings, a previous study reported that hepatic steatosis evaluated by FLI might contribute to CKD development. 11 Elevated albuminuria is well known to be associated with increased risk for early diabetes renal damage; however, the identification and classification of kidney disease were assessed only by eGFR in that study. Moreover, 731 adults who underwent routine health evaluations were included in that study and the small sample size cannot better represent the whole population.…”

Section: Discussionmentioning

confidence: 98%

“…Recently, a cross-sectional study was conducted to investigate the association between FLI and CKD by recruiting adults undergoing a health check-up. 11 However, by including only 731 subjects, the study did not evaluate the association between FLI and albuminuria, either. Therefore, we analysed data from a community-based Chinese population to comprehensively look into the relationship of FLI with both increased urinary albumin excretion and CKD.…”

Section: Introductionmentioning

confidence: 99%

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Fatty liver index, albuminuria and the association with chronic kidney disease: a population-based study in China

Sun

Lin

et al. 2018

BMJ Open

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ObjectivesThe effects of lipid metabolism disorder on renal damage have drawn much attention. Using the fatty liver index (FLI) as a validated indicator of hepatic steatosis, this study aims to provide insight about the possible links between fatty liver and the development of chronic kidney disease (CKD).SettingHospital.ParticipantsWe performed a population-based study on 9436 subjects aged 40 years or older.Primary and secondary outcome measuresFLI is calculated using an algorithm based on body mass index, waist circumference, triglycerides and γ-glutamyltransferase. Increased urinary albumin excretion was defined according to the urinary albumin to creatinine ratio ranges ≥30 mg/g. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² or presence of albuminuria.ResultsThere were 620 (6.6%) subjects categorised to have increased urinary albumin excretion and 753 (8.0%) subjects categorised to have CKD. Participants with higher FLI had increased age, blood pressure, low-density lipoprotein cholesterol, fasting plasma glucose, fasting insulin and decreased eGFR level. Prevalence of increased urinary albumin excretion and CKD tended to increase with the elevated FLI quartiles. In logistic regression analysis, compared with subjects in the lowest quartile of FLI, the adjusted ORs in the highest quartile were 2.30 (95% CI 1.36 to 3.90) for increased urinary albumin excretion and 1.93 (95% CI 1.18 to 3.15) for CKD.ConclusionHepatic steatosis evaluated by FLI is independently associated with increased urinary albumin excretion and prevalence of CKD in middle-aged and elderly Chinese.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Fatty liver index, albuminuria and the association with chronic kidney disease: a population-based study in China

Sun

Lin

et al. 2018

BMJ Open

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“…The liver disease‐related mortality rates of NAFLD and NASH patients were 0.77‰ (95% CI 0.33‰–1.77‰) and 11.77‰ (95% CI 7.10‰–19.53‰), and the all‐cause mortality rates were 15.44‰ (95% CI 11.72‰–20.34‰) and 25.56‰ (95% CI 6.29‰–103.80‰), respectively . Furthermore, NAFLD patients, especially those with NASH, have been found to be associated with high incidences of osteoporosis, chronic kidney disease, colorectal carcinoma, breast cancer and some other chronic diseases . In “lean” NAFLD, especially NASH, patients with high homeostasis model assessment‐IR (HOMA‐IR) also have a high risk of metabolic and cardiovascular diseases and progressive liver disease …”

Section: Nature History and Follow‐upmentioning

confidence: 99%

Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China)

Fan

Wei

Zhang

2018

J of Digest Diseases

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158

132

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“…NAFLD has been shown to be associated with CKD [ 6 ]. Furthermore, a recent study reported that CKD is likely to be more common in adults with NAFLD than in those without it [ 32 ]. Patients with NAFLD have insulin resistance and hypercoagulability (high fibrinogen, factor VII, and von Willebrand factor levels), which are risk factors for CKD [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatic Steatosis Index and Chronic Kidney Disease among Middle-Aged Individuals: A Large-Scale Study in Japan

et al. 2021

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Background. Though nonalcoholic fatty liver disease (NAFLD) is related to chronic kidney disease (CKD), it is unclear whether the hepatic steatosis index (HSI), a screening tool for NAFLD, is related to CKD. The present study investigated the relationship between HSI and CKD among middle-aged individuals in Japan. Methods. Subjects were adults (aged 40–64 years) who received an annual health checkup in Japan between April 2013 and March 2014. Height and weight were measured, and venous blood samples were obtained to determine alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine levels. HSI was calculated by the following formula: HSI = 8 × ALT / AST ratio + body mass index (+2, if diabetes; +2, if female). CKD was defined as an estimated glomerular filtration rate < 60 mL / min / 1.73 m 2 and/or urinary protein of ≥ (+). Logistic regression analysis was performed to estimate the odds ratio (OR) and its 95% confidence interval (CI) for CKD. Results. Data of 94,893 adults were analyzed. Compared with men with an HSI < 30 , men with 30 ≤ HSI ≤ 36 (OR: 1.50, 95% CI: 1.40–1.61) and HSI > 36 (OR: 2.14, 95% CI: 1.99–2.31) had significantly higher ORs for CKD. Moreover, there was a significant dose-response relationship between HSI and CKD ( P for trend < 0.001 ). Even after adjusting for confounders, the significant results persisted. These findings in men were similar to those in women. Conclusions. This study showed that the HSI was associated with CKD among middle-aged adults in Japan. Additionally, a dose-response relationship of HSI to CKD was observed. The present study suggested that it might be useful to monitor the HSI among middle-aged individuals to detect CKD at an early stage.

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Association between non‐invasively diagnosed hepatic steatosis and chronic kidney disease in Chinese adults on their health check‐up

Abstract: A diagnosis of hepatic steatosis is related to an increased risk of CKD among non-alcoholic and non-diabetic Chinese adults regardless of whether the diagnosis was acquired via ultrasound, CAP or FLI. Increased hepatic lipid content may contribute to CKD development.

Cited by 15 publications

References 29 publications

Fatty liver index, albuminuria and the association with chronic kidney disease: a population-based study in China

Fatty liver index, albuminuria and the association with chronic kidney disease: a population-based study in China

Guidelines of prevention and treatment of nonalcoholic fatty liver disease (2018, China)

Hepatic Steatosis Index and Chronic Kidney Disease among Middle-Aged Individuals: A Large-Scale Study in Japan

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