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

Sun, Kan; Lin, Diaozhu; Li, Feng; Qi, Yiqin; Feng, Wei; Yan, Li; Chen, Chaogang; Ren, Meng; Liú, Dan

doi:10.1136/bmjopen-2017-019097

Cited by 26 publications

(21 citation statements)

References 38 publications

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“…Proteinuria also predicts patients at increased risk of adverse clinical outcomes regardless of the estimated glomerular filtration rate (eGFR) [ 6 ]. In addition, proteinuria has been regarded as a manifestation of endothelial dysfunction and systemic inflammation [ 7 ] and has recently been linked to the risk of chronic systemic inflammatory diseases [ 8 , 9 , 10 , 11 , 12 , 13 ]. However, there is no evidence on the impact of proteinuria on the incidence of IBD.…”

Section: Introductionmentioning

confidence: 99%

Proteinuria Is Associated with the Development of Crohn’s Disease: A Nationwide Population-Based Study

Park

Lee

Han

et al. 2021

JCM

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Background and Aims: The impact of proteinuria and its severity on the incidence of inflammatory bowel disease (IBD) has not yet been studied. We aimed to determine the association between proteinuria measured by urine dipstick tests and the development of IBD. Methods: This nationwide population-based study was conducted using the Korean National Health Insurance Service (NHIS) database. A total of 9,917,400 people aged 20 years or older who had undergone a national health examination conducted by the NHIS in 2009 were followed up until 2017. The study population was classified into four groups—negative, trace, 1+, and ≥ 2+—according to the degree of proteinuria measured by the urine dipstick test. The primary endpoint was newly diagnosed IBD, Crohn’s disease (CD), or ulcerative colitis (UC) during the follow-up period. Results: Compared with the dipstick-negative group, the incidence of CD significantly increased according to the degree of proteinuria (adjusted hazard ratio [aHR] with 95% confidence interval [CI], 1.01 [0.703–1.451], 1.515 [1.058–2.162], and 2.053 [1.301–3.24] in the trace, 1+, and ≥ 2+ dipstick groups, respectively; p for trend 0.007). However, there was no significant difference in the incidence of UC according to the degree of proteinuria (aHR with 95% CI, 1.12 [0.949–1.323], 0.947 [0.764–1.174], and 1.009 [0.741–1.373] in the trace, 1+, and ≥ 2+ dipstick groups, respectively; p for trend 0.722). In the subgroup analysis, dipstick-positive proteinuria independently increased the incidence of CD regardless of the subgroup. However, dipstick-positive proteinuria was associated with the risk of UC in those with diabetes mellitus and not in those without diabetes mellitus (aHR, 1.527 vs. 0.846; interaction p-value 0.004). The risk of CD was increased or decreased according to proteinuria changes but not associated with the risk of UC. Conclusion: Proteinuria, measured by the dipstick test, is strongly associated with the development of CD.

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Section: Introductionmentioning

confidence: 99%

Proteinuria Is Associated with the Development of Crohn’s Disease: A Nationwide Population-Based Study

Park

Lee

Han

et al. 2021

JCM

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“…Dyslipidaemia has always been regarded as the cornerstone of arteriosclerosis and the primary target of therapy according to international guidelines [11, 12]. In addition, it has been reported that dyslipidaemia associated with arteriosclerotic complications is the most common cause of death in chronic kidney disease (CKD) patients, and dyslipidaemia has also been shown to be an independent risk factor for the progression of CKD [13, 14]. Furthermore, a previous meta-analysis demonstrated that statins for treatment of dyslipidaemia may be beneficial for the reduction of albuminuria in CKD patients [15].…”

Section: Introductionmentioning

confidence: 99%

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Wang

et al. 2019

Cardiovasc Diabetol

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Background Dyslipidaemia has always been regarded as the cornerstone of arteriosclerosis and is related to the pathogenesis of renal insufficiency. However, it is unclear which routinely available lipid parameter is related to urinary albumin to creatinine ratio (UACR). The purpose of this study was to examine the lipid abnormalities associated with UACR in the general population in China. Methods The present study was nested in an ongoing Risk Evaluation of cAncers in Chinese diabetic Individuals: A lONgitudinal (REACTION) study, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. This cross-sectional study included 34, 569 subjects (11, 390 males and 23, 179 females) from 8 different regional community cohorts, with an average age of 57.9 years. The UACR data were divided into the < 25% group, the 25–49% group, the 50–74% group, and the ≥ 75% group according to the quartile division of the centre where the subjects visited. The lipid classes were defined according to the guidelines for the prevention and treatment of dyslipidaemia in Chinese adults. Multiple logistic regression analysis was used to evaluate the association of the lipid parameters and UACR. Results Multivariable regression analysis revealed that compared with the other lipid parameters, triglycerides (TG) showed an adjusted odds ratio that was significant in model 1–4. This relationship was attenuated after adjusting for Haemoglobin A1c (HbA1c) and blood pressure (BP), but TG ≥ 2.3 mmol/L was still significantly associated with UACR in total subjects and in both men and women (OR: 1.131, 95% CI 1.065–1.203, P < 0.001 in total subjects; OR: 1.134, 95% CI 1.022–1.258, P = 0.017 in men; OR: 1.129, 95% CI 1.046–1.219, P = 0.002 in women). In the stratified analysis, elevated TG was significantly associated with increased urinary albumin in subjects with eGFR ≥ 90 mL/min per 1.73 m 2 , 5.6 ≤ FBG < 7.0 or 7.8 ≤ PBG < 11.1 mmol/L, 24 ≤ BMI < 28 kg/m 2 , 120 ≤ SBP < 140 and/or 80 ≤ DBP < 90 mmHg. Conclusions We conclude that high TG levels rather than total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or non-high-density lipoprotein cholesterol levels are associated with UACR in the general population in China. Electronic supplementary material The online version of this article (10.1186/s12933-019-0863-8) contains supplementary material, which is available to authorized users.

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“…It has been estimated that 25% of the global population have non-alcoholic fatty liver disease (NAFLD), with highest prevalence in the Middle East and South America and lowest prevalence in Africa 1 2. Of greater concern is the association of fatty liver with extrahepatic diseases, such as type 2 diabetes, cardiovascular diseases (CVDs) and chronic kidney disease 3–5. It is therefore logical to speculate association of FLD with increased mortality risk consequent on the association of these diseases with increased mortality globally 6…”

Section: Introductionmentioning

confidence: 99%

Association of fatty liver disease with mortality outcomes in an Eastern Finland male cohort

Olubamwo

Virtanen

Pihlajamäki

et al. 2019

BMJ Open Gastroenterol

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ObjectiveFatty liver disease (FLD) has been associated with extrahepatic morbidity outcomes. However, reports on the association of FLD, assessed using fatty liver index (FLI), with mortality outcomes have been inconsistent. Our objective was to examine the effect of metabolic factors (blood pressure, insulin, fasting glucose, lipoproteins) on the associations of FLI with mortality outcomes among middle-aged men.Study designProspective cohort study.MethodsOur subjects were 1893 men at baseline from 1984 to 1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study cohort. Multivariable Cox regression models were used to analyse the association of baseline FLI, with the HRs for all-cause, disease, cardiovascular, non-cardiovascular and cancer mortality outcomes.ResultsThe mean FLI in the FLI categories were 16.2 in the low and reference category (FLI<30), 43.4 in the intermediate FLI category (FLI=30–<60) and 77.5 in the high FLI (FLD) category (FLI≥60). Over an average follow-up of 20 years, 848 disease deaths were recorded through Finnish national cause of death register. In models adjusted for constitutional, lifestyle and inflammatory factors, for the high (FLI≥60) vs low (FLI<30) FLI category, the HRs (95% CI) for mortality outcomes were 1.50 (1.26–1.78) for all-cause mortality; 1.56 (1.31–2.86) for disease mortality; 1.51 (1.18–1.94) for cardiovascular disease (CVD) mortality; 1.42 (1.12–1.80) for non-CVD mortality and 1.45 (1.02–2.07) for cancer mortality. With further adjustment for metabolic factors, the HRs were 1.25 (1.01–1.53) for all-cause mortality; 1.26 (1.02–1.56) for disease mortality; 1.06 (0.78–1.43) for CVD mortality; 1.46 (1.09–1.94) for non-CVD mortality and 1.49 (0.97–2.29) for cancer mortality.ConclusionHigh FLI (FLD) is associated with increased risks of mortality outcomes. The FLI-CVD mortality association can be largely explained by metabolic factors. Persons with FLD should be monitored for metabolic deterioration and extrahepatic morbidity to improve their prognoses.

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

Cited by 26 publications

References 38 publications

Proteinuria Is Associated with the Development of Crohn’s Disease: A Nationwide Population-Based Study

Proteinuria Is Associated with the Development of Crohn’s Disease: A Nationwide Population-Based Study

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Association of fatty liver disease with mortality outcomes in an Eastern Finland male cohort

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