https://orcid.org/0000-0003-1908-4454
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Abstract
Objective
To explore the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM).
Methods
A total of 1168 patients with T2DM were divided into the non-CKD and CKD groups, and the difference in the prevalence of NAFLD was compared. The differences in serum creatinine (SCr) and urine albumin-to-creatinine ratio (UACR) levels were compared between the non-NAFLD and NAFLD groups. Patients with T2DM were divided into three groups according to their UACR levels (UACR < 30 mg/g [U1 group]; UACR ≤ 30 mg/g to < 300 mg/g [U2 group]; and UACR ≥ 300 mg/g [U3 group]) or estimated glomerular filtration rate (eGFR) levels (≥ 90 mL/min [G1 group]; eGFR ≤ 60 mL/min to < 90 mL/min [G2 group]; and eGFR < 60 mL/min (G3 group]). The difference in the prevalence and risks of NAFLD in the different UACR or eGFR level groups was analyzed.
Results
The prevalence of NAFLD in the CKD group was higher than that in the non-CKD group (63.5% vs 50.5%, p < 0.001). The SCr and UACR levels in the NAFLD group were higher than those in the non-NAFLD group (both p<0.05). The prevalence of NAFLD in the U3 group (75.6%) was higher than that in the U1 (50.5%, p < 0.05) and U2 (60.1%, p < 0.05) groups, and the prevalence of NAFLD in the U2 group (60.1%) was higher than that in the U1 group (50.5%, p < 0.05). The risk of NAFLD in the U3 group was higher than that in the U2 group (odds ratio [OR] = 3.032 and 1.473). Despite adjusting the parameters further, the NAFLD risk in the U3 group remained higher than that in the U2 group (OR = 1.660 and 2.342).
Conclusion
The risk of NAFLD in patients with T2DM is closely related to CKD.
Abbreviations
T2DM, type 2 diabetes mellitus; NAFLD, non-alcoholic fatty liver disease; CKD, chronic kidney disease; BMI, body mass index; HP, hypertension; SBP, systolic blood pressure; DBP, diastolic blood pressure; AST, aspartate aminotransferase; ALT, alanine aminotransferase; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase; TG, triglycerides; TC, total cholesterol; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; SUA, serum uric acid; HbAlc, glycosylated hemoglobin; FPG, fasting plasma glucose; 2hPG, 2-hour postprandial blood glucose; FINS, fasting insulin; HOMA-IR, homeostasis model assessment of insulin resistance; SCr, serum creatinine; BUN, blood urea nitrogen; eGFR, estimated glomerular filtration rate; UACR, urinary albumin creatinine ratio.
Data Sharing Statement
The data of this study is not publicly available due to data protection by the First Hospital of Lanzhou University. However, these are available from the corresponding author on reasonable request.
Ethics Approval
All procedures performed in studies involving human participants were in accordance with the institutional ethical standards, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, the approval number is LDYYLL2021-337.
Consent for Publication
All authors support the submission to this journal.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors declare that they have no conflicts of interest for this work.