Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older
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Background: Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common pathogenic mechanisms and many risk factors, and both are linked to an increased risk of cardiovascular diseases. The aim of this study was to assess the association between NAFLD and CKD according to the presence of hypertension and diabetes mellitus in Koreans aged 50 years or older. Methods: A cross-sectional study of 1,706 subjects who received their routine health examination was conducted between May 2008 and April 2010 at Konkuk University medical center. Biochemical tests for liver and abdominal ultrasonography were performed. CKD was defined as either proteinuria or glomerular filtration rate ≤60 mL/min per 1.73 m2. Results: Among the 1,706 subjects, There were 545 (31.9%) with non-alcoholic fatty liver disease and 424 (24.9%) with chronic kidney disease. In univariate logistic regression analysis, NAFLD was significantly associated with CKD (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.34 to 2.12). In multivariate logistic regression analysis adjusted for age,sex, current smoking, abdominal obesity, aspartate aminotransferases, alanine aminotransferases, γ-glutamyltransferase,hypertension, diabetes mellitus, hypertriglyceridemia, and low high-density lipoprotein cholesterol, NAFLD was associated with CKD (adjusted OR, 1.68; 95% CI, 1.27 to 2.24). This relationship remained significant after classification according to the presence of hypertension or diabetes mellitus. Conclusion: NAFLD diagnosed by ultrasonography was significantly associated with CKD in Koreans aged 50 years or older.
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common pathogenic mechanisms and many risk factors, and both are linked to an increased risk of cardiovascular diseases. The aim of this study was to assess the association between NAFLD and CKD according to the presence of hypertension and diabetes mellitus in Koreans aged 50 years or older. Methods: A cross-sectional study of 1,706 subjects who received their routine health examination was conducted between May 2008 and April 2010 at Konkuk University medical center. Biochemical tests for liver and abdominal ultrasonography were performed. CKD was defined as either proteinuria or glomerular filtration rate ≤60 mL/min per 1.73 m2. Results: Among the 1,706 subjects, There were 545 (31.9%) with non-alcoholic fatty liver disease and 424 (24.9%) with chronic kidney disease. In univariate logistic regression analysis, NAFLD was significantly associated with CKD (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.34 to 2.12). In multivariate logistic regression analysis adjusted for age,sex, current smoking, abdominal obesity, aspartate aminotransferases, alanine aminotransferases, γ-glutamyltransferase,hypertension, diabetes mellitus, hypertriglyceridemia, and low high-density lipoprotein cholesterol, NAFLD was associated with CKD (adjusted OR, 1.68; 95% CI, 1.27 to 2.24). This relationship remained significant after classification according to the presence of hypertension or diabetes mellitus. Conclusion: NAFLD diagnosed by ultrasonography was significantly associated with CKD in Koreans aged 50 years or older.
참고문헌 (30)
- Adams LA, "Nonalcoholic fatty liver disease", Ann Epidemiol, 17, pp.863~869 (2007)
- de Alwis NM, "Non-alcoholic fatty liver disease: the mist gradually clears", J Hepatol, 48(Suppl 1), pp.S104~S112 (2008)
- Wiegand J, "Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis", Internist (Berl), 48, pp.154~163 (2007)
- Targher G, "Risk of chronic kidney disease in patients with non-alcoholic fatty liver disease: is there a link?", J Hepatol, 54, pp.1020~1029 (2011)
- Park SH, "Current status of liver disease in Korea: nonalcoholic fatty liver disease", Korean J Hepatol, 15(Suppl 6), pp.S34~S39 (2009)
- Angulo P, "Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis", Hepatology, 30, pp.1356~1362 (1999)
- Sarnak MJ, "Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention", Circulation, 108, pp.2154~2169 (2003)
- Stevens LA, "Assessing kidney function: measured and estimated glomerular filtration rate", N Engl J Med, 354, pp.2473~2483 (2006)
- Stevens LA, "Chronic kidney disease and end-stage renal disease in the elderly population: current prevalence, future projections, and clinical significance", Adv Chronic Kidney Dis, 17, pp.293~301 (2010)
- Targher G, "Non-alcoholic fatty liver disease is independently associated with an increased prevalence of chronic kidney disease and retinopathy in type 1 diabetic patients", Diabetologia, 53, pp.1341~1348 (2010)
- Chang Y, "Nonalcoholic fatty liver disease predicts chronic kidney disease in nonhypertensive and nondiabetic Korean men", Metabolism, 57, pp.569~576 (2008)
- Suzuki H, "Chronic kidney disease in postmenopausal women", Hypertens Res, 35, pp.142~147 (2012)
- Yeon JE, "The clinical implication of non-alcoholic fatty liver disease", J Korean Acad Fam Med, 24, pp.510~515 (2003)
- Tolstrup JS, "Alcohol intake, alcohol dehydrogenase genotypes, and liver damage and disease in the Danish general population", Am J Gastroenterol, 104, pp.2182~2188 (2009)
- Mulhall BP, "Non-alcoholic fatty liver disease: an overview", J Gastroenterol Hepatol, 17, pp.1136~1143 (2002)
- Saadeh S, "The utility of radiological imaging in nonalcoholic fatty liver disease", Gastroenterology, 123, pp.745~750 (2002)
- Adams LA, "Nonalcoholic fatty liver disease", CMAJ, 172, pp.899~905 (2005)
- O’Shea RS, "Alcoholic liver disease", Am J Gastroenterol, 105, pp.14~32 (2010)
- Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, "Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III)", JAMA, 285, pp.2486~2497 (2001)
- Targher G, "Relationship between serum gamma-glutamyltransferase and chronic kidney disease in the United States adult population: findings from the National Health and Nutrition Examination Survey 2001-2006", Nutr Metab Cardiovasc Dis, 20, pp.583~590 (2010)
- Ryu S, "gamma- Glutamyltransferase as a predictor of chronic kidney disease in nonhypertensive and nondiabetic Korean men", Clin Chem, 53, pp.71~77 (2007)
- Lee DH, "Serum gammaglutamyltransferase was differently associated with microalbuminuria by status of hypertension or diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Study", Clin Chem, 51, pp.1185~1191 (2005)
- Hwang ST, "Impact of non-alcoholic fatty liver disease on microalbuminuria in patients with prediabetes and diabetes", Intern Med J, 40, pp.437~442 (2010)
- Targher G, "Increased risk of CKD among type 2 diabetics with nonalcoholic fatty liver disease", J Am Soc Nephrol, 19, pp.1564~1570 (2008)
- Badman MK, "The adipocyte as an active participant in energy balance and metabolism", Gastroenterology, 132, pp.2103~2115 (2007)
- Vuppalanchi R, "Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Selected practical issues in their evaluation and management", Hepatology, 49, pp.306~317 (2009)
- Kronenberg F, "Emerging risk factors and markers of chronic kidney disease progression", Nat Rev Nephrol, 5, pp.677~689 (2009)
- Targher G, "Increased prevalence of cardiovascular disease in Type 2 diabetic patients with non-alcoholic fatty liver disease", Diabet Med, 23, pp.403~409 (2006)
- Yoneda M, "High-sensitivity C-reactive protein is an independent clinical feature of nonalcoholic steatohepatitis (NASH) and also of the severity of fibrosis in NASH", J Gastroenterol, 42, pp.573~582 (2007)
- Targher G, "Nonalcoholic fatty liver disease as a contributor to hypercoagulation and thrombophilia in the metabolic syndrome", Semin Thromb Hemost, 35, pp.277~287 (2009)
