Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease.

Agile 3+ Agile 4 Impaired renal function Metabolic syndrome Nonalcoholic fatty liver disease

Journal

Hepatobiliary & pancreatic diseases international : HBPD INT
ISSN: 1499-3872
Titre abrégé: Hepatobiliary Pancreat Dis Int
Pays: Singapore
ID NLM: 101151457

Informations de publication

Date de publication:
03 Aug 2023
Historique:
received: 15 03 2023
accepted: 31 07 2023
medline: 25 8 2023
pubmed: 25 8 2023
entrez: 24 8 2023
Statut: aheadofprint

Résumé

Nonalcoholic fatty liver disease (NAFLD) is associated with impaired renal function, and both diseases often occur alongside other metabolic disorders. However, the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear. The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients. All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study. Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase (FAST), Agile 3+ and Agile 4 scores. Impaired renal function and chronic kidney disease (CKD) were defined by an estimated glomerular filtration rate (eGFR) with value of < 90 mL/min/1.73 m Among 529 included NAFLD patients, the prevalence rates of impaired renal function and CKD were 37.4% and 4.9%, respectively. In multivariate analysis, a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile3+ and Agile 4 scores were independent risk factors for CKD (P < 0.05). Furthermore, increased fasting plasma glucose (FPG) and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome (P < 0.05). Compared with patients with normoglycemia, those with prediabetes [FPG ≥ 5.6 mmol/L or hemoglobin A1c (HbA1c) ≥ 5.7%] were more likely to have impaired renal function (P < 0.05). Agile 3+ and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD. Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

Sections du résumé

BACKGROUND BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is associated with impaired renal function, and both diseases often occur alongside other metabolic disorders. However, the prevalence and risk factors for impaired renal function in patients with NAFLD remain unclear. The objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD patients.
METHODS METHODS
All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective study. Liver fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase (FAST), Agile 3+ and Agile 4 scores. Impaired renal function and chronic kidney disease (CKD) were defined by an estimated glomerular filtration rate (eGFR) with value of < 90 mL/min/1.73 m
RESULTS RESULTS
Among 529 included NAFLD patients, the prevalence rates of impaired renal function and CKD were 37.4% and 4.9%, respectively. In multivariate analysis, a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile3+ and Agile 4 scores were independent risk factors for CKD (P < 0.05). Furthermore, increased fasting plasma glucose (FPG) and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome (P < 0.05). Compared with patients with normoglycemia, those with prediabetes [FPG ≥ 5.6 mmol/L or hemoglobin A1c (HbA1c) ≥ 5.7%] were more likely to have impaired renal function (P < 0.05).
CONCLUSIONS CONCLUSIONS
Agile 3+ and Agile 4 are reliable for identifying NAFLD patients with high risk of CKD. Early glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

Identifiants

DOI: 10.1016/j.hbpd.2023.08.004 PMID: 37620227
pubmed: 37620227
pii: S1499-3872(23)00123-6
doi: 10.1016/j.hbpd.2023.08.004
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Competing interest Wah-Kheong Chan has served as a consultant or advisory board member for Roche, AbbVie, Boehringer Ingelheim, and Novo Nordisk, and as a speaker for Hisky Medical and Viatris. Vincent Wai-Sun Wong has served as a consultant or advisory board member for 3V-BIO, AbbVie, Allergan, Boehringer Ingelheim, Center for Outcomes Research in Liver Diseases, Echosens, Gilead Sciences, Hanmi Pharmaceutical, Intercept, Merck, Novartis, Novo Nordisk, Perspectum Diagnostics, Pfizer, ProSciento, Sagimet Biosciences, TARGET-NASH, and Terns; and as a speaker for AbbVie, Bristol-Myers Squibb, Echosens, and Gilead Sciences. Other authors have no conflict of interest.

Auteurs

Chao Sun (C)

Center for Fatty Liver Disease, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China.

George Boon-Bee Goh (GB)

Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Singapore.

Wan-Cheng Chow (WC)

Department of Gastroenterology & Hepatology, Singapore General Hospital, Singapore, Singapore.

Wah-Kheong Chan (WK)

Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Grace Lai-Hung Wong (GL)

Department of Medicine and Therapeutics and State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.

Wai-Kay Seto (WK)

Department of Medicine, The University of Hong Kong, Hong Kong, China.

Yi-Hsiang Huang (YH)

Institute of Clinical Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, China; Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan, China.

Han-Chieh Lin (HC)

Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan, China; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, China.

I-Cheng Lee (IC)

Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan, China; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan, China.

Hye Won Lee (HW)

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Seung Up Kim (SU)

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Vincent Wai-Sun Wong (VW)

Department of Medicine and Therapeutics and State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China. Electronic address: wongv@cuhk.edu.hk.

Jian-Gao Fan (JG)

Center for Fatty Liver Disease, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China. Electronic address: fanjiangao@xinhuamed.com.cn.

Classifications MeSH