Fatty Liver Index, Albuminuria and the Association with Chronic Kidney Disease: a Population-based Study in China

Overview

Journal BMJ Open

Specialty General Medicine

Date 2018 Feb 1

PMID 29382678

Citations 16

Authors

Kan Sun

Diaozhu Lin

Feng Li

Yiqin Qi

Wanting Feng

Li Yan

Chaogang Chen

Meng Ren

Dan Liu

Affiliations

Soon will be listed here.

Abstract

Objectives: The 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).

Setting: Hospital.

Participants: We performed a population-based study on 9436 subjects aged 40 years or older.

Primary And Secondary Outcome Measures: FLI 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.

Results: There 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.

Conclusion: Hepatic 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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References

Zhang Q, Qi W, Wang X, Zhang Y, Xu Y, Qin S . Epidemiology of Hepatitis B and Hepatitis C Infections and Benefits of Programs for Hepatitis Prevention in Northeastern China: A Cross-Sectional Study. Clin Infect Dis. 2015; 62(3):305-12. DOI: 10.1093/cid/civ859. View

Musso G, Gambino R, Tabibian J, Ekstedt M, Kechagias S, Hamaguchi M . Association of non-alcoholic fatty liver disease with chronic kidney disease: a systematic review and meta-analysis. PLoS Med. 2014; 11(7):e1001680. PMC: 4106719. DOI: 10.1371/journal.pmed.1001680. View

Parker R, Kim S, Gao B . Alcohol, adipose tissue and liver disease: mechanistic links and clinical considerations. Nat Rev Gastroenterol Hepatol. 2017; 15(1):50-59. DOI: 10.1038/nrgastro.2017.116. View

Bi Y, Lu J, Wang W, Mu Y, Zhao J, Liu C . Cohort profile: risk evaluation of cancers in Chinese diabetic individuals: a longitudinal (REACTION) study. J Diabetes. 2013; 6(2):147-57. DOI: 10.1111/1753-0407.12108. View

. Standards of medical care in diabetes--2014. Diabetes Care. 2013; 37 Suppl 1:S14-80. DOI: 10.2337/dc14-S014. View

Huh J, Ahn S, Koh S, Choi E, Kim J, Sung K . A Prospective Study of Fatty Liver Index and Incident Hypertension: The KoGES-ARIRANG Study. PLoS One. 2015; 10(11):e0143560. PMC: 4664241. DOI: 10.1371/journal.pone.0143560. View

Sun K, Liu J, Ning G . Active smoking and risk of metabolic syndrome: a meta-analysis of prospective studies. PLoS One. 2012; 7(10):e47791. PMC: 3474781. DOI: 10.1371/journal.pone.0047791. View

Sun K, Lu J, Jiang Y, Xu M, Xu Y, Zhang J . Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders. Clin Endocrinol (Oxf). 2013; 80(3):348-55. DOI: 10.1111/cen.12168. View

Hu L, Huang X, You C, Li J, Hong K, Li P . Prevalence of overweight, obesity, abdominal obesity and obesity-related risk factors in southern China. PLoS One. 2017; 12(9):e0183934. PMC: 5598943. DOI: 10.1371/journal.pone.0183934. View

10.

Matsushita K, Coresh J, Sang Y, Chalmers J, Fox C, Guallar E . Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol. 2015; 3(7):514-25. PMC: 4594193. DOI: 10.1016/S2213-8587(15)00040-6. View

11.

Xu C, Yu C, Ma H, Xu L, Miao M, Li Y . Prevalence and risk factors for the development of nonalcoholic fatty liver disease in a nonobese Chinese population: the Zhejiang Zhenhai Study. Am J Gastroenterol. 2013; 108(8):1299-304. DOI: 10.1038/ajg.2013.104. View

12.

Zeng J, Sun C, Sun W, Chen G, Pan Q, Yan S . Association between non-invasively diagnosed hepatic steatosis and chronic kidney disease in Chinese adults on their health check-up. J Dig Dis. 2017; 18(4):229-236. DOI: 10.1111/1751-2980.12465. View

13.

Meex R, Watt M . Hepatokines: linking nonalcoholic fatty liver disease and insulin resistance. Nat Rev Endocrinol. 2017; 13(9):509-520. DOI: 10.1038/nrendo.2017.56. View

14.

Matsushita K, van der Velde M, Astor B, Woodward M, Levey A, de Jong P . Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet. 2010; 375(9731):2073-81. PMC: 3993088. DOI: 10.1016/S0140-6736(10)60674-5. View

15.

Bedogni G, Bellentani S, Miglioli L, Masutti F, Passalacqua M, Castiglione A . The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 2006; 6:33. PMC: 1636651. DOI: 10.1186/1471-230X-6-33. View

16.

Gaggini M, Morelli M, Buzzigoli E, DeFronzo R, Bugianesi E, Gastaldelli A . Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients. 2013; 5(5):1544-60. PMC: 3708335. DOI: 10.3390/nu5051544. View

17.

Lee Y, Jung K, Kim S, Yoon H, Yun Y, Lee B . Sarcopaenia is associated with NAFLD independently of obesity and insulin resistance: Nationwide surveys (KNHANES 2008-2011). J Hepatol. 2015; 63(2):486-93. DOI: 10.1016/j.jhep.2015.02.051. View

18.

Kozakova M, Palombo C, Eng M, Dekker J, Flyvbjerg A, Mitrakou A . Fatty liver index, gamma-glutamyltransferase, and early carotid plaques. Hepatology. 2012; 55(5):1406-15. DOI: 10.1002/hep.25555. View

19.

Giorda C, Forlani G, Manti R, Mazzella N, De Cosmo S, Rossi M . Occurrence over time and regression of nonalcoholic fatty liver disease in type 2 diabetes. Diabetes Metab Res Rev. 2016; 33(4). DOI: 10.1002/dmrr.2878. View

20.

Xi B, Liang Y, He T, Reilly K, Hu Y, Wang Q . Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009. Obes Rev. 2011; 13(3):287-96. PMC: 3276709. DOI: 10.1111/j.1467-789X.2011.00944.x. View