Tags

Type your tag names separated by a space and hit enter

Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease.
Diabetes Metab J. 2022 07; 46(4):630-639.DM

Abstract

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM.

METHODS

In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2.

RESULTS

At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009).

CONCLUSION

Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.Department of Biomedical Sciences, Inha University College of Medicine, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.Huh's Diabetes Center, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

35081304

Citation

Seo, Da Hea, et al. "Advanced Liver Fibrosis Is Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease." Diabetes & Metabolism Journal, vol. 46, no. 4, 2022, pp. 630-639.
Seo DH, Suh YJ, Cho Y, et al. Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease. Diabetes Metab J. 2022;46(4):630-639.
Seo, D. H., Suh, Y. J., Cho, Y., Ahn, S. H., Seo, S., Hong, S., Lee, Y. H., Choi, Y. J., Lee, E., & Kim, S. H. (2022). Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease. Diabetes & Metabolism Journal, 46(4), 630-639. https://doi.org/10.4093/dmj.2021.0130
Seo DH, et al. Advanced Liver Fibrosis Is Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease. Diabetes Metab J. 2022;46(4):630-639. PubMed PMID: 35081304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advanced Liver Fibrosis Is Associated with Chronic Kidney Disease in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease. AU - Seo,Da Hea, AU - Suh,Young Ju, AU - Cho,Yongin, AU - Ahn,Seong Hee, AU - Seo,Seongha, AU - Hong,Seongbin, AU - Lee,Yong-Ho, AU - Choi,Young Ju, AU - Lee,Eunjig, AU - Kim,So Hun, Y1 - 2022/01/26/ PY - 2021/06/23/received PY - 2021/10/24/accepted PY - 2022/1/27/pubmed PY - 2022/8/9/medline PY - 2022/1/26/entrez KW - Diabetes mellitus, type 2 KW - Fibrosis KW - Liver KW - Non-alcoholic fatty liver disease KW - Renal insufficiency, chronic SP - 630 EP - 639 JF - Diabetes & metabolism journal JO - Diabetes Metab J VL - 46 IS - 4 N2 - BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is associated with chronic kidney disease (CKD). However, the causal relationship between NAFLD and CKD is uncertain, particularly in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association between the presence and severity of NAFLD and incident CKD in patients with T2DM. METHODS: In this longitudinal cohort study of patients with T2DM, 3,188 patients with preserved renal function were followed up for the occurrence of incident CKD. NAFLD was defined as the presence of hepatic steatosis on ultrasonography, without any other causes of chronic liver disease. Advanced liver fibrosis of NAFLD was defined as a fibrosis-4 index ≥2.67. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. RESULTS: At baseline, 1,729 (54.2%) patients had NAFLD, of whom 94 (5.4%) had advanced liver fibrosis. During the follow-up of 8.3±3.6 years, 472 (14.8%) patients developed incident CKD: 220 (15.1%) in the non-NAFLD group, 231 (14.1%) in the NAFLD without advanced fibrosis group and 28 (31.1%) in the NAFLD with advanced fibrosis group. There was no increased risk of incident CKD in the NAFLD group compared to the non-NAFLD group (P=0.435). However, among patients with NAFLD, advanced liver fibrosis was associated with an increased risk of CKD (adjusted hazard ratio, 1.75; 95% confidence interval, 1.15 to 2.66; P=0.009). CONCLUSION: Advanced liver fibrosis in patients with NAFLD is independently associated with an increased risk of incident CKD in patients with T2DM. SN - 2233-6087 UR - https://www.unboundmedicine.com/medline/citation/35081304/Advanced_Liver_Fibrosis_Is_Associated_with_Chronic_Kidney_Disease_in_Patients_with_Type_2_Diabetes_Mellitus_and_Nonalcoholic_Fatty_Liver_Disease_ DB - PRIME DP - Unbound Medicine ER -