Premium
Lower eGFR is associated with increased probability of liver fibrosis in Chinese diabetic patients
Author(s) -
Wang Yuying,
Yu Yuetian,
Wan Heng,
Chen Yi,
Xia Fangzhen,
Zhang Wen,
Zhang Kun,
Gu Xinjie,
Zhang Yihao,
Lin Zhiqi,
Yu Yuefeng,
Wang Ningjian,
Lu Yingli
Publication year - 2020
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3294
Subject(s) - medicine , fibrosis , gastroenterology , renal function , nonalcoholic fatty liver disease , diabetes mellitus , insulin resistance , steatosis , receiver operating characteristic , fatty liver , transient elastography , obesity , liver fibrosis , endocrinology , disease
Background Kidney dysfunction is linked to nonalcoholic fatty liver disease (NAFLD) progression including fibrosis, steatosis, or inflammation. We aimed to explore whether lower levels of estimated glomerular filtration rate (eGFR) was associated with increased probability of liver fibrosis. Methods Two thousand six hundred eighty‐nine subjects enrolled from Shanghai, China, were included in this study. NAFLD fibrosis score (NFS) was used to risk stratify NAFLD patients for fibrosis. eGFR was used to assess kidney function. The association of eGFR level with elevated NFS, and thus high risk of fibrosis, was analysed by linear regression and multinomial logistic regression. The predictive power of eGFR was evaluated via receiver operating characteristic (ROC) curve. Results A negative association was found between eGFR and NFS (B = −0.21, 95% CI, −0.37 to −0.04, P = .016). As eGFR quartiles decreased, the prevalence of probable fibrosis increased after adjusting for age, sex, current smoking, waist circumference, duration of diabetes, HbA 1c , hypertension, dyslipidaemia, and homeostasis model assessment index of insulin resistance (HOMA‐IR) (Q4: reference; Q3: 1.49, 95% CI, 0.82‐2.71; Q2: 1.88, 95% CI, 0.97‐3.67; Q1: 2.70, 95% CI, 1.36‐5.37, P for trend = .002, 1SD increment: 0.73, 95% CI, 0.58‐0.92). The eGFR level can be an effective indicator in differentiating patients with probable presence of fibrosis from those without (AUROC: 0.71, cut‐off point: 92.78 mL/min/1.73 m 2 , P < .001). Conclusions Lower levels of eGFR were associated with higher NFS and thus greater risk of presence of fibrosis in patients with NAFLD and T2DM. Individuals with NAFLD and diabetes should carefully monitor eGFR and receive regular urinalysis, especially when advanced fibrosis is suspected.