Alkaline phosphatase is independently associated with renal function in normoalbuminuric type 1 diabetic patients

Figures & data

Table 1. Clinical and metabolic characteristics of all patients.

Variable	Value
Age (years)	34 (18–65)
Duration of diabetes (years)	12 (1–42)
Body mass index (kg/m^2)	24 (15–37)
Waist to hip ratio	0.81 ± 0.07
Fasting glucose (mmol/L)	5.4 (2.7–10.2)
Hemoglobin A1c (%)	7.43 ± 1.63
Systolic blood pressure (mmHg)	120 (79–180)
Diastolic blood pressure (mmHg)	80 (50–100)
Total cholesterol (mmol/L)	5.0 ± 0.8
LDL cholesterol (mmol/L)	2.8 ± 0.7
HDL cholesterol (mmol/L)	1.7 ± 0.4
Triglycerides (mmol/L)	0.91 (0.3–4.1)
AST (units/L)	20 (10–146)
ALT (units/L)	19 (7–171)
ALK (units/L)	69 (11–229)
GGT (units/L)	16 (7–553)
Bilirubin (µmol/L)	12 (5–103)
Ferritin (µg/L)	55 (5–697)
Serum creatinine (µmol/L)	71 ± 14
eGFR (mL/min/1.73 m^2)	106 ± 16
Urinary albumin excretion (mg/24 h)	11.0 (1.7–29.8)

Note: eGFR, estimated glomerular filtration rate.

Table 2. Spearman correlation analysis of associations of NAFLD markers and renal function parameters with metabolic parameters.

Variable	AST	ALT	ALK	GGT	Bilirubin	Creatinine	UAE	eGFR
Duration of diab.	0.04	0.03	−0.06	0.14*	−0.04	0.00	0.14*	−0.29*
BMI	0.07	0.05	0.13*	0.01	0.13*	0.15*	−0.02	−0.10
WHR	0.14*	0.25*	0.25*	0.37*	0.16*	0.39*	0.01	−0.02
HBA1c	0.06	0.11*	0.14*	0.11*	−0.13*	−0.14*	0.07	0.15*
Total cholesterol	0.01	0.05	0.02	0.16*	−0.14*	−0.01	0.02	−0.21*
LDL cholesterol	−0.08	0.07	0.05	0.14*	−0.81	0.08	0.03	−0.18*
HDL cholesterol	0.01	−0.11*	−0.13*	−0.03	−0.09	−0.19*	−0.13*	−0.17*
Triglycerides	0.02	0.18*	0.19*	0.23*	−0.03	0.07	0.11*	0.06
Systolic BP	0.06	0.09	0.12*	0.13*	0.08	0.11*	0.09	−0.08
Diastolic BP	−0.05	0.02	0.16*	0.11*	0.03	0.08	0.23*	−0.01
Serum creatinine	0.01	0.16*	0.01	0.18*	0.29*
eGFR	0.05	0.01	0.23*	−0.01	−0.12*
UAE	−0.05	0.04	0.06	0.11*	0.03

Notes: BMI, body mass index; WHR, waist to hip ratio; HbA1c, hemoglobin A1c; GFR, estimated glomerular filtration rate; UAE, urinary albumin excretion rate.

*p < 0.05.

Table 3. Quartiles of serum creatinine.

	1st quartile (<63 µmol/L)	2nd quartile (≥63 < 71)	3rd quartile(≥71 < 80)	4th quartile (≥80 µmol/L)	P for trend
AST (units/L)	20 (10–146)	20 (12–113)	19 (12–143)	21 (12–55)	0.3
ALT (units/L)	18 (9–146)	19 (7–69)	18 (8–171)	23 (10–120)	0.007
ALK (units/L)	68 (34–208)	66 (36–125)	69 (25–229)	71 (11–120)	0.7
GGT (units/L)	14 (8–213)	15 (7–117)	17 (7–553)	18 (8–100)	0.006
Bil. (µmol/L)	10 (5–43)	12 (6–31)	13 (5–46)	14 (7–113)	0.001

Note: Bil, bilirubin.

Table 4. Levels of NAFLD markers depending on level of estimated glomerular filtration rate.

Variable	eGFR > 60 ≤ 90	eGFR > 90 ≤ 125 mL/min/1.73 m^2	eGFR > 125	p
AST (units/L)	18 (12–42)	20 (10–143)	21 (13–146)	0.02
ALT (units/L)	18 (8–58)	20 (7–171)	20 (10–146)	0.1
ALK (units/L)	64 (11–120)	68 (34–202)	81 (38–229)	<0.001
GGT (units/L)	15 (7–48)	16 (7–753)	16 (8–54)	0.5
Bilirubin (µmol/L)	13 (7–46)	13 (5–113)	9 (5–28)	0.02

Table 5. Multivariate logistic regression analysis of NAFLD markers with risk of progression of renal disease in type 1 diabetes.

Independent variable	Group	Model A	Model B
AST	1	1.00 (0.98–1.02)	1.00 (0.98–1.02)
	2	0.98 (0.96–1.00)	0.98 (0.96–1.00)
	3	1.00 (0.98–1.02)	0.99 (0.97–1.02)
ALT	1	1.01 (0.99–1.02)	1.01 (0.99–1.02)
	2	0.99 (0.97–0.99)	1.00 (0.98–1.01)
	3	0.98 (0.97–1.00)	0.98 (0.96–0.99)
ALK	1	1.00 (0.99–1.01)	1.00 (0.99–1.01)
	2	0.98 (0.97–0.99)*	0.98 (0.97–0.99)*
	3	1.01 (1.00–1.03)*	1.02 (1.00–1.03)*
GGT	1	1.01 (0.99–1.02)	1.00 (0.99–1.02)
	2	0.99 (0.99–1.00)	0.99 (0.99–1.00)
	3	0.99 (0.99–1.00)	0.99 (0.99–1.00)
Bilirubin	1	0.99 (0.96–1.02)	0.99 (0.97–1.02)
	2	1.03 (0.99–1.07)	1.03 (0.99–1.07)
	3	0.97 (0.93–1.00)	0.97 (0.94–1.01)

Notes: Group 1: urinary albumin excretion rate; Group 2: serum creatinine; Group 3: estimated glomerular filtration rate.

Data are OR (95% CI) from separate models. Model A adjusted for age and sex; model B adjusted for age, sex, duration of diabetes, BMI, and HbA1c.

*p < 0.05.