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Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically proven non-cirrhotic NAFLD

Sun, D. Q. ; Ye, F. Z. ; Kani, H. T. ; Yang, J. R. ; Zheng, K. I. ; Zhang, H. Y. LU orcid ; Targher, G. ; Byrne, C. D. ; Chen, Y. P. and Yuan, W. J. , et al. (2020) In Diabetes and Metabolism 46(4). p.288-295
Abstract

Aim: The association between Liver fibrosis (LF), as assessed by either histology or Liver stiffness measurement (LSM), and the presence of Early kidney dysfunction (EKD) was investigated in this study, as was also the diagnostic performance of LSM for identifying the presence of EKD in patients with Non-alcoholic fatty liver disease (NAFLD). Materials and methods: A total of 214 adults with non-cirrhotic biopsy-proven NAFLD were recruited from two independent medical centres. Their histological stage of LF was quantified using Brunt's criteria. Vibration-controlled Transient elastography (TE), using M-probe (FibroScan®) ultrasound, was performed in 154 patients and defined as significant when LSM was ≥ 8.0 kPa. EKD was defined as the... (More)

Aim: The association between Liver fibrosis (LF), as assessed by either histology or Liver stiffness measurement (LSM), and the presence of Early kidney dysfunction (EKD) was investigated in this study, as was also the diagnostic performance of LSM for identifying the presence of EKD in patients with Non-alcoholic fatty liver disease (NAFLD). Materials and methods: A total of 214 adults with non-cirrhotic biopsy-proven NAFLD were recruited from two independent medical centres. Their histological stage of LF was quantified using Brunt's criteria. Vibration-controlled Transient elastography (TE), using M-probe (FibroScan®) ultrasound, was performed in 154 patients and defined as significant when LSM was ≥ 8.0 kPa. EKD was defined as the presence of microalbuminuria with an estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2. Logistic regression modelling was used to estimate the likelihood of having EKD with NAFLD (LSM–EKD model). Results: The prevalence of EKD was higher in patients with vs without LF on histology (22.14% vs 4.82%, respectively; P < 0.001) and, similarly, EKD prevalence was higher in patients with LSM ≥ 8.0 kPa vs LSM < 8.0 kPa (23.81% vs 6.59%, respectively; P < 0.05). The area under the ROC curve of the LSM–EKD model for identifying EKD was 0.80 (95% CI: 0.72–0.89). LF detected by either method was associated with EKD independently of established renal risk factors and potential confounders. Conclusion: LF was independently associated with EKD in patients with biopsy-proven NAFLD. Thus, TE-measured LSM, a widely used technique for quantifying LF, can accurately identify those patients with NAFLD who are at risk of having EKD.

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publishing date
type
Contribution to journal
publication status
published
keywords
Early kidney dysfunction, Liver fibrosis, Liver stiffness measurement, Non-alcoholic fatty liver disease
in
Diabetes and Metabolism
volume
46
issue
4
pages
288 - 295
publisher
Elsevier Masson SAS
external identifiers
  • pmid:31786360
  • scopus:85077926152
ISSN
1262-3636
DOI
10.1016/j.diabet.2019.11.003
language
English
LU publication?
no
additional info
Publisher Copyright: © 2019 Elsevier Masson SAS
id
37a7ec8d-0bbb-4c17-a17b-8c02d5e025fb
date added to LUP
2024-02-05 15:55:51
date last changed
2024-04-22 00:09:48
@article{37a7ec8d-0bbb-4c17-a17b-8c02d5e025fb,
  abstract     = {{<p>Aim: The association between Liver fibrosis (LF), as assessed by either histology or Liver stiffness measurement (LSM), and the presence of Early kidney dysfunction (EKD) was investigated in this study, as was also the diagnostic performance of LSM for identifying the presence of EKD in patients with Non-alcoholic fatty liver disease (NAFLD). Materials and methods: A total of 214 adults with non-cirrhotic biopsy-proven NAFLD were recruited from two independent medical centres. Their histological stage of LF was quantified using Brunt's criteria. Vibration-controlled Transient elastography (TE), using M-probe (FibroScan®) ultrasound, was performed in 154 patients and defined as significant when LSM was ≥ 8.0 kPa. EKD was defined as the presence of microalbuminuria with an estimated glomerular filtration rate ≥ 60 mL/min/1.73 m<sup>2</sup>. Logistic regression modelling was used to estimate the likelihood of having EKD with NAFLD (LSM–EKD model). Results: The prevalence of EKD was higher in patients with vs without LF on histology (22.14% vs 4.82%, respectively; P &lt; 0.001) and, similarly, EKD prevalence was higher in patients with LSM ≥ 8.0 kPa vs LSM &lt; 8.0 kPa (23.81% vs 6.59%, respectively; P &lt; 0.05). The area under the ROC curve of the LSM–EKD model for identifying EKD was 0.80 (95% CI: 0.72–0.89). LF detected by either method was associated with EKD independently of established renal risk factors and potential confounders. Conclusion: LF was independently associated with EKD in patients with biopsy-proven NAFLD. Thus, TE-measured LSM, a widely used technique for quantifying LF, can accurately identify those patients with NAFLD who are at risk of having EKD.</p>}},
  author       = {{Sun, D. Q. and Ye, F. Z. and Kani, H. T. and Yang, J. R. and Zheng, K. I. and Zhang, H. Y. and Targher, G. and Byrne, C. D. and Chen, Y. P. and Yuan, W. J. and Yilmaz, Y. and Zheng, M. H.}},
  issn         = {{1262-3636}},
  keywords     = {{Early kidney dysfunction; Liver fibrosis; Liver stiffness measurement; Non-alcoholic fatty liver disease}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{288--295}},
  publisher    = {{Elsevier Masson SAS}},
  series       = {{Diabetes and Metabolism}},
  title        = {{Higher liver stiffness scores are associated with early kidney dysfunction in patients with histologically proven non-cirrhotic NAFLD}},
  url          = {{http://dx.doi.org/10.1016/j.diabet.2019.11.003}},
  doi          = {{10.1016/j.diabet.2019.11.003}},
  volume       = {{46}},
  year         = {{2020}},
}