Association Between the Risk of Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes and Chronic Kidney Disease

Figures & data

Figure 1 Diagram of the study design.

Table 1 Comparison of the Prevalence of NAFLD and the Other Indicators Between CKD and Non-CKD Groups

	Non-CKD (n=774)	CKD (n=394)	P
Male/Female-n (%)	481(62.1)/293(37.9)	256(65)/138(35.0)	0.343
Age (years)	57.98±11.61	62.97±29.86	<0.001
BMI (kg/m^2)	24.48±3.30	24.64±3.29	0.465
Duration(years)	7(3,13)	10(5,17)	<0.001
HP-n(%)	365(47.2)	251(63.7)	<0.001
SBP(mmHg)	138.94±21.99	146.94±25.46	<0.001
DBP(mmHg)	82.94±22.30	85.29±37.82	0.183
AST(U/L)	20(17,26)	23(18,30)	<0.001
ALT(U/L)	22(16,33)	20(15,30)	0.032
GGT(U/L)	25.40(18.90,42.38)	26.55(18.90,43.70)	0.238
ALP	79(65,99)	87(73,104)	<0.001
TG(mmol/L)	1.56(1.1,2.26)	1.66(1.12,2.55)	0.082
TC(mmol/L)	4.34±1.20	4.34±1.27	0.963
HDL-C(mmol/L)	1.04±0.28	1.00±0.25	0.024
LDL-C(mmol/L)	2.71±0.79	2.64±0.84	0.165
SUA(μmol/L)	323.67±102.43	347.66±95.75	<0.001
HbAlc (%)	8.37±2.02	9.14±2.21	<0.001
FPG(mmol/L)	9.15±4.32	9.97±3.22	0.001
2hPG(mmol/L)	17.37±11.86	18.79±5.07	0.024
FINS(mU/L)	7.24(4.95,10.55)	7.58(5.00,10.98)	0.671
HOMA-IR	2.82(1.77,4.25)	3.16(2.02,4.56)	0.009
SCr(μmol/L)	67.50±14.70	85.42±52.00	<0.001
BUN(mmol/L)	5.86±3.81	7.09±5.11	<0.001
eGFR(mL/min)	106.78±38.84	92.04±41.49	<0.001
UACR(mg/g)	11.44(7.64,16.66)	77.37(44.15,252.12)	<0.001
NAFLD-n(%)	391(50.5)	250(63.5)	<0.001

Abbreviations: 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; NAFLD, nephropathy and nonalcoholic fatty liver disease.

Figure 2 Comparison of the SCr, UACR, and eGFR levels between the NAFLD and non-NAFLD groups. (A) SCr level, (B) eGFR level, (C) UACR level.

Abbreviations: SCr, serum creatinine; eGFR, estimated glomerular filtration rate; UACR, urinary albumin creatinine ratio; NAFLD, non-alcoholic fatty liver disease.

Figure 3 Comparison of the prevalence of NAFLD in the different UACR level groups or eGFR level groups. (A) The prevalence of NAFLD in different UACR levels groups, (B) the prevalence of NAFLD in different eGFR levels groups.

Abbreviations: eGFR, estimated glomerular filtration rate; UACR, urinary albumin creatinine ratio; NAFLD, non-alcoholic fatty liver disease.

Table 2 Correlation Between NAFLD and CKD in T2DM Patients by Univariate Logistic Regression Analysis

Variables	β	OR	95% CI	P
Male(reference)
Female	0.291	1.337	1.052,1.701	0.018
Age	−0.015	0.985	0.975,0.995	0.002
Duration	−0.055	0.947	0.930,0.963	<0.001
BMI	0.258	1.295	1.238,1.354	<0.001
SBP	0.007	1.007	1.002,1.012	0.004
DBP	0.002	1.002	0.997,1.007	0.406
AST	0.03	1.030	1.019,1.042	<0.001
ALT	0.018	1.018	1.011,1.025	<0.001
ALP	0.008	1.008	1.004,1.012	<0.001
GGT	0.014	1.014	1.010,1.019	<0.001
TG	0.311	1.365	1.232,1.512	<0.001
TC	0.357	1.429	1.280,1.596	<0.001
HDL-C	−1.027	0.358	0.226,0.568	<0.001
LDL-C	0.114	1.121	0.971,1.295	0.12
SUA	0.003	1.003	1.002,1.005	<0.001
HbAlc	0.08	1.084	1.025,1.145	0.005
FPG	0.071	1.074	1.032,1.117	<0.001
2hPG	0.020	1.020	0.997,1.044	0.09
FINS	0.007	1.007	0.994,1.020	0.29
HOMA-IR	0.031	1.032	1.000,1.06–52	0.049
SCr	0.007	1.007	1.003,1.012	0.003
BUN	−0.029	0.972	0.940,1.005	0.097
eGFR	−0.007	0.993	0.989,0.997	0.001
UACR	0.003	1.003	1.002,1.005	<0.001

Abbreviations: BMI, body mass index; duration, duration of diabetes; BP, 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.

Table 3 Risk Analysis of NAFLD in the Different UACR Levels by Stratified Logistic Regression Analysis

Dependent Variables	Model	OR(95% CI)	p
U1 group		0^a
U2 group	Model 1	1.473(1.127,1.926)	0.005
	Model 2	1.762(1.279,2.428)	0.001
	Model 3	1.660(1.193,2.310)	0.003
U3 group	Model 1	3.032(1.817,5.058)	<0.001
	Model 2	3.601(1.966,6.596)	<0.001
	Model 3	2.342(1.203,4.559)	0.012

Notes: ^aReference group. Model 1, not adjusted; Model 2, adjusted sex, age, duration of diabetes, BMI, SBP, AST, ALT, ALP, GGT, TG, TC and HDL-C; Model 3, adjusted Model 2+ SUA, HbAlc, FPG, HOMA-IR SCr, BUN and eGFR.

Abbreviations: OR, odds ratio; CI, confidence interval.