Increased microalbuminuria prevalence among patients with nonalcoholic fatty liver disease

Kasapoğlu, Benan; Türkay, Cansel; Yalcin, Kadir Serkan; Boğa, Salih; Bozkurt, Alper

doi:10.3109/0886022x.2015.1106845

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…In the present study, we found that approximately one fifth of the patients with MAFLD had microalbuminuria with eGFR ≥60 mL/min/1.73 m 2 , defined as EKD. Previous evidence showed an increased risk of albuminuria among patients with MAFLD [33][34][35][36][37], even in those without DM [38]. It has been postulated that MAFLD could contribute to albuminuria by enhancing the endothelial dysfunction from the systemic inflammation [16,39].…”

Section: Discussionmentioning

confidence: 99%

Early Kidney Dysfunction in Metabolic-Associated Fatty Liver Disease: Is Transient Elastography Useful as a Screening Method?

Freitas

Silva

Xavier

et al. 2021

Dig Dis

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Introduction: Increasing evidence suggests an association between metabolic associated fatty liver disease (MAFLD) and chronic kidney disease (CKD). Timely prediction of early kidney dysfunction (EKD) is thus essential in this population, although a screening method is not stablished. We aimed to evaluate the role of transient elastography (TE) in predicting EKD in patients with MAFLD. Methods: Prospective cohort study that included patients with MAFLD scheduled for evaluation, between May/2019 and January/2020. Demographic, clinical and laboratory data, and TE parameters were obtained. EKD was defined as microalbuminuria (urinary albumin-to-creatinine ratio 30-300mg/g) and estimated glomerular filtration rate≥60mL/min/1.73m2. Significant liver fibrosis was defined as liver stiffness measurement (LSM)≥8.2kPa. Results: Included 45 patients with MALFD, 53.3% female gender, mean age of 53.5±10.9years. EKD was found in 17.8% of patients. MAFLD patients with EKD were significantly more obese (body mass index≥30) (75.0% vs 32.4%,p=0.045) and had significantly higher LSM (8.5±4.1 vs 5.8±2.2kPa,p=0.01). After adjustment of potential confounders for EKD the presence of liver fibrosis, remained a significant predictor of EKD, being associated with a 14.3-fold increased risk of EKD (p=0.04). The optimal cutoff value of LSM to predict EKD was 6.1kPa (sensitivity:85.7%; specificity:67.6%). Conclusion: Significant liver fibrosis is associated with a significant increased risk of EKD in patients with MAFLD, regardless of other comorbidities. Higher levels of LSM, particularly >6.1kPa, alert for timely identification of EKD and associated comorbidities, as well as their control, in order to prevent the development of CKD in the long term.

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Section: Discussionmentioning

confidence: 99%

Early Kidney Dysfunction in Metabolic-Associated Fatty Liver Disease: Is Transient Elastography Useful as a Screening Method?

Freitas

Silva

Xavier

et al. 2021

Dig Dis

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“…Some studies have focused on the association between NAFLD and microalbuminuria 38-41. Casoinic et al enrolled patients with type 2 DM and showed there was a positive association between NAFLD and microalbuminuria 39.…”

Section: Discussionmentioning

confidence: 99%

Non-alcoholic fatty liver disease is associated with low-grade albuminuria in men without diabetes mellitus

2019

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Background: Non-alcoholic fatty liver disease (NAFLD) is associated with the dysregulation of multiple metabolic and inflammatory pathways. These can lead to extrahepatic disorders involving the kidney, a vulnerable organ responsible for extra-renal complications. Evaluating the association between NAFLD and low-grade albuminuria as a renal complication would be helpful to better understand the pathophysiology and extra-hepatic complications of NAFLD.Patients and Methods: Our study extracted data from database obtained a representative population sample. Overall, 3867 men were included in this survey. Our study included only men without diabetes mellitus, with a urinary albumin/creatinine ratio < 30 mg/g (n = 1390). Low-grade albuminuria was defined by a urinary albumin/creatinine ratio within the highest quartile. The fatty liver index was calculated in accordance with Bedogni's equation. We defined the NAFLD group as patients with a fatty liver index of ≥ 60.Results: In the multivariate analysis, the urinary albumin/creatinine ratio in the non-NAFLD and NAFLD groups was 3.05 ± 0.14 and 5.19 ± 0.42, respectively (P < 0.001). The correlation coefficients between the fatty liver index and urinary albumin/creatinine ratio were 0.124 in the Pearson's correlation test and 0.084 in the partial correlation test (P < 0.001 and P = 0.002, respectively). Linear regression analysis showed a positive association between the fatty liver index and the urinary albumin/creatinine ratio on multivariate analysis. Logistic regression analysis showed that the odds ratio for low-grade albuminuria with NAFLD was 2.31 (95% confidence interval, 1.47-3.61; P < 0.001) on the multivariate analysis. Subgroup analyses according to the presence of metabolic syndrome or age (< 50 or ≥ 50 years) showed that the association between NAFLD and the urinary albumin/creatinine ratio was stronger for participants without metabolic syndrome and in those aged < 50 years.Conclusion: NAFLD was associated with low-grade albuminuria in men without diabetes mellitus in this study. Therefore, men with a relatively high fatty liver index or NAFLD should be closely monitored for low-grade albuminuria, especially in absence of metabolic syndrome.

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“…In this meta-analyses, however, all of the studies included did not exclude the influence of PNPLA3 I148M Variant on circulating RBP4 levels. In addition, a number of studies have indicated that circulating RBP4 concentrations were associated with renal dysfunction [ 34 – 36 ], and NAFLD has been found to be associated with decreased estimated glomerular filtration rate (eGFR) and/or microalbuminuria [ 37 , 38 ]. Although some of the studies in this meta-analysis referred to the exclusion criteria that did not include subjects with renal dysfunction, we are not sure if it was strictly controlled, and some of the studies did not refer to the exclusion.…”

Section: Discussionmentioning

confidence: 99%

Circulating retinol binding protein 4 levels in nonalcoholic fatty liver disease: a systematic review and meta-analysis

Zhou

Chen

et al. 2017

Lipids Health Dis

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BackgroundRetinol binding protein 4 (RBP4) is implicated in obesity, insulin resistance and type 2 diabetes mellitus that are closely associated with nonalcoholic fatty liver disease (NAFLD). However, recent investigations regarding circulating RBP4 levels in NAFLD are conflicting. This meta-analysis is to determine whether NAFLD, non-alcoholic steatohepatitis (NASH) and simple steatosis (SS) patients have altered RBP4 levels.MethodsWe performed a systematic search in PubMed, EMBASE and The Cochrane Library up until 18 March 2017, and 12 studies comprising a total of 4247 participants (2271 NAFLD patients and 1976 controls) were included in the meta-analysis.ResultsThere were no significant differences of circulating RBP4 levels in the following comparisons: (1) NAFLD patients vs controls (standardized mean differences [SMD]: 0.08; 95% CI: −0.21, 0.38); (2) NASH patients vs controls (SMD: −0.49; 95% CI: −1.09, 0.12); (3) SS patients vs controls (SMD: −0.72; 95% CI: −1.64, 0.20) and (4) NASH vs SS patients (SMD: −0.04; 95% CI: −0.32, 0.24). The results remained essentially unchanged in the comparisons between NAFLD patients and controls after excluding single individual study or bariatric studies (n = 2). No significant publication bias was detected. However, there was significant heterogeneity among studies and the subgroup and meta-regression analyses did not find the potential sources.ConclusionsCirculating RBP4 levels may not be associated with NAFLD. Further prospective cohort studies are required to confirm these findings.Electronic supplementary materialThe online version of this article (10.1186/s12944-017-0566-7) contains supplementary material, which is available to authorized users.

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Increased microalbuminuria prevalence among patients with nonalcoholic fatty liver disease

Cited by 12 publications

References 24 publications

Early Kidney Dysfunction in Metabolic-Associated Fatty Liver Disease: Is Transient Elastography Useful as a Screening Method?

Early Kidney Dysfunction in Metabolic-Associated Fatty Liver Disease: Is Transient Elastography Useful as a Screening Method?

Non-alcoholic fatty liver disease is associated with low-grade albuminuria in men without diabetes mellitus

Circulating retinol binding protein 4 levels in nonalcoholic fatty liver disease: a systematic review and meta-analysis

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