3 years ago

Advanced liver fibrosis but not steatosis is independently associated with albuminuria in Chinese patients with type 2 diabetes

Advanced liver fibrosis but not steatosis is independently associated with albuminuria in Chinese patients with type 2 diabetes
Increasing evidence suggests that non-alcoholic fatty liver disease (NAFLD) may be an independent risk factor for chronic kidney disease (CKD). Given the high prevalence of NAFLD among patients with diabetes who are also at risk for CKD, we aimed to investigate the association between NAFLD and albuminuria, a marker commonly found in diabetic nephropathy. Methods This study included a cohort of Chinese patients with type 2 diabetes from the Hong Kong Diabetes Registry recruited between March 2013 and May 2014. Liver stiffness measurement (LSM) with probe-specific cut-offs were used to detect advanced liver fibrosis while controlled attenuation parameter (CAP) was used to assess liver steatosis using transient elastography. Results A total of 1763 Chinese patients with type 2 diabetes were recruited in this analysis. The mean (standard deviation) age and disease duration of diabetes were 60.7 (11.5) years and 10.8 (8.5) years respectively. The prevalence of albuminuria was higher in diabetic patients with liver steatosis and those with advanced fibrosis (no NAFLD vs. liver steatosis vs. advanced fibrosis: 41.4% vs. 46.2% vs. 64.2%, p<0.001). After adjustment of potential confounders including glycated haemoglobin, hypertension and body mass index, advanced fibrosis but not liver steatosis was associated with increased risk of albuminuria (odd ratio, OR =1.52, 95% confidence interval, CI: 1.02-2.28, p =0.039) in patients with eGFR ≥60 ml/min/1.73 m2. The odds of albuminuria increased with greater severity of liver fibrosis in a dose dependent manner with the highest odds observed in patients with LSM scores ≥11.5kPa assessed by M-probe or ≥11.0kPa assessed by XL-probe (adjusted OR= 1.53, 95% CI: 1.07-2.20, p=0.021). Conclusions Advanced liver fibrosis is independently associated with albuminuria in Chinese patients with type 2 diabetes. Lay summary In this study, we assessed the link between non-alcoholic fatty liver disease (NAFLD) and albuminuria in a cohort of 1763 Chinese patients with type 2 diabetes. This study shows that advanced liver fibrosis, a severe form of NAFLD, was independently associated with increased risk of albuminuria. The risk of albuminuria increased with greater severity of liver fibrosis.

Publisher URL: www.sciencedirect.com/science

DOI: S0168827817323346

You might also like
Never Miss Important Research

Researcher is an app designed by academics, for academics. Create a personalised feed in two minutes.
Choose from over 15,000 academics journals covering ten research areas then let Researcher deliver you papers tailored to your interests each day.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.