JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (7): 43-49.doi: 10.6040/j.issn.1671-7554.0.2015.1001

Previous Articles     Next Articles

Association between nonalcoholic fatty liver disease and chronic kidney disease: a retrospective cohort study

SHEN Zhenwei1, JI Xiaokang2, WANG Qinglian3, LI Jie1, XUE Fuzhong1, LIU Jing1   

  1. 1. Department of Biostatistics, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Information and Data Analysis Lab, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    3. Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Received:2015-10-21 Online:2016-07-10 Published:2016-07-10

PDF (PC)

200

Abstract: Objective To explore the effect of nonalcoholic fatty liver disease(NAFLD)on the incidence of chronic kidney disease(CKD). Methods A retrospective cohort study was conducted using the data of regular physical examinations derived from the Health Management Center of Shandong Provincial Hospital. Participants who had physical examinations ≥3 times during 2005 and 2010 and whose renal function was normal at the first examination were included. Comparisons of the baseline characteristics between the participants with and without NAFLD were conducted with Student-t test or Pearson chi-square test. The cumulative incidences of CKD were estimated using Kaplan-Meier method for subjects with and without NAFLD at baseline respectively. Log-rank test was adopted to identify the difference between groups. Firstly, univariate Cox regression models were used to explore the association between the hazard of 山 东 大 学 学 报 (医 学 版)54卷7期 -申振伟,等.非酒精性脂肪肝与慢性肾脏病关系的回顾性队列研究 \=-CKD and the relevant factors such as demographic characteristics and biochemical measures. Further, multiple Cox regression model was used to estimate the effect of NAFLD on the incidence of CKD after adjusting these potential confounders. Results The cohort included 10 775 subjects and 34 878 person-years(average 3.24±0.99 years per person)were followed up. There were 1 068 CKD cases during the study period, and the incidence was 30.62/1 000 person-years. The cumulative CKD incidence of subjects with NAFLD at baseline was significantly higher than that of without NAFLD(22.76 vs 12.07, P<0.01). After adjusting the factors including age, gender, body mass index, systolic blood pressure, fasting blood-glucose, triglyceride, high density lipoprotein, hemoglobin, thrombocytocrit, hypertension, diabetes, metabolic syndrome and history of coronary heart disease, the HR of NAFLD to non-NAFLD on CKD was 1.20(95% CI: 1.05-1.38, P=0.01). Conclusion The existence of NAFLD was confirmed to be one independent risk factor for CKD in Chinese population. This finding will be helpful for prevention of CKD.

Key words: Chronic kidney disease, Cox regression, Cohort, Non-alcoholic fatty liver disease

CLC Number: 

  • R692
[1] Blagg CR. Chronic kidney disease is a growing worldwide public health problem. Preface[J]. Hemodial Int, 2011, 15(3): 303-305.
[2] Matsushita K, van der Velde M, Astor BC, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis[J]. Lancet, 2010, 375(9731): 2073-2081.
[3] Zhang L, Wang F, Wang L, et al. Prevalence of chronic kidney disease in China: a cross-sectional survey[J]. Lancet, 2012, 379(9818): 815-822.
[4] Targher G, Pichiri I, Zoppini G, et al. Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liver[J]. Diabet Med, 2012, 29(2): 220-226.
[5] Ahn AL, Choi JK, Kim MN, et al. Non-alcoholic fatty liver disease and chronic kidney disease in Koreans aged 50 years or older[J]. Korean J Fam Med, 2013, 34(3): 199-205.
[6] Li G, Shi W, Hug H, et al. Nonalcoholic fatty liver disease associated with impairment of kidney function in nondiabetes population[J]. Biochem Med(Zagreb), 2012, 22(1): 92-99.
[7] El AH, Khalek E, El-Akabawy H, et al. Association between nonalcoholic fatty liver disease and the incidence of cardiovascular and renal events[J]. J Saudi Heart Assoc, 2013, 25(4): 239-246.
[8] Armstrong MJ, Houlihan DD, Bentham L, et al. Presence and severity of non-alcoholic fatty liver disease in a large prospective primary care cohort[J]. J Hepatol, 2012, 56(1): 234-240.
[9] Sirota JC, Mcfann K, Targher G, et al. Association between nonalcoholic liver disease and chronic kidney disease: an ultrasound analysis from NHANES 1988-1994[J]. Am J Nephrol, 2012, 36(5): 466-471.
[10] Casoinic F, Sampelean D, Badau C, et al. Nonalcoholic fatty liver disease-a risk factor for microalbuminuria in type 2 diabetic patients[J]. Rom J Intern Med, 2009, 47(1): 55-59.
[11] Fan JG, Farrell GC. Epidemiology of non-alcoholic fatty liver disease in China[J]. J Hepatol, 2009, 50(1): 204-210.
[12] 高西美, 王静, 杨晓云, 等. 济南市体检人群脂肪肝检出率及危险因素[J]. 山东大学学报(医学版), 2012, 50(6): 119-121. GAO Ximei, WANG Jing, YANG Xiaoyun, et al. Detectable rate and risk factors of fatty liver in the Jinan physical examination population[J]. Journal of Shandong University(Health Science), 2012, 50(6): 119-121.
[13] 卢艳慧, 陆菊明, 王淑玉, 等. 国际糖尿病联盟与中国糖尿病学会关于代谢综合征诊断标准的比较分析[J]. 中华医学杂志, 2006, 86(6): 386-389. LU Yanhui, LU Juming, WANG Shuyu, et al. Comparison of the diagnostic criteria of metabolic syndrome by International Diabetes Federation and that by Chinese Medical Association Diabetes Branch[J]. Natl Med J China, 2006, 86(6):386-389.
[14] Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate[J]. Ann Intern Med, 2009, 150(9): 604-612.
[15] 中华医学会肝病学分会脂肪肝和酒精性肝病学组. 非酒精性脂肪性肝病诊疗指南(2010年修订版)[J]. 中华肝脏病杂志, 2010, 18(3): 163-166. The Chinese National Workshop on Fatty Liver and Alcohol & Liver Disease for the Chinese Liver Disease Association. Guidelines for management of nonalcoholic fatty liver disease: an updated and revised edition[J]. Chinese Journal of Hepatology, 2010, 18(3): 163-166.
[16] Xia MF, Lin HD, Li XM, et al. Renal function-dependent association of serum uric acid with metabolic syndrome and hepatic fat content in a middle-aged and elderly Chinese population[J]. Clin Exp Pharmacol Physiol, 2012, 39(11): 930-937.
[17] Targher G, Chonchol M, Zoppini G, et al. Risk of chronic kidney disease in patients with non-alcoholic fatty liver disease: is there a link?[J]. J Hepatol, 2011, 54(5): 1020-1029.
[18] Navarro-Gonzalez JF, Mora C, Muros M, et al. Relationship between inflammation and microalbuminuria in prehypertension[J]. J Hum Hypertens, 2013, 27(2): 119-125.
[19] Li HJ, Li CP, Zhang C, et al. Association of Adiponectin gene polymorphisms and nonalcoholic fatty liver disease[J]. Int J Clin Exp Med, 2015, 8(9): 16676-16681.
[20] Lim CC, Teo BW, Tai ES, et al. Elevated serum leptin, adiponectin and leptin to adiponectin ratio is associated with chronic kidney disease in asian adults[J]. PLoS One, 2015, 10(3): e122009. doi: 10.1371/journal.pone.0122009.
[21] Ix JH, Sharma K. Mechanisms linking obesity, chronic kidney disease, and fatty liver disease: the roles of fetuin-A, adiponectin, and AMPK[J]. J Am Soc Nephrol, 2010, 21(3): 406-412.
[22] Targher G, Chonchol MB, Byrne CD. CKD and nonalcoholic fatty liver disease[J]. Am J Kidney Dis, 2014, 64(4): 638-652.
[1] CAO Jin, JI Xiaokang, SUN Xiubin, JIANG Zheng, XUE Fuzhong. The relationship between γ-glutamyltransferase and hyperuricemia: a cohort study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 124-128.
[2] LIU Yafei, XING Ping, XU Xiuqin, YANG Shufang, LIU Yanxun, YUAN Zhongshang, XUE Fuzhong. Shandong multi-center longitudinal cohort for health management: a brief introduction [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 30-36.
[3] YU Tao, LIU Huanle, FENG Xin, XU Fuyin, CHEN Yafei, XUE Fuzhong, ZHANG Chengqi. A hypertension risk prediction model based on health management cohort [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 61-65.
[4] WANG Chunxia, XU Yibo, YANG Ning, XIA Bing, WANG Ping, XUE Fuzhong. A prediction model for coronary heart disease risks based on health management cohort [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 66-71.
[5] ZHANG Guang, WANG Guangyin, WU Hongyan, ZHANG Hongyu, WANG Tingting, LI Jiqing, LI Min, KANG Fengling, LIU Yanxun, XUE Fuzhong. A prediction model of hyperlipidemia risk based on the health management population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 72-76.
[6] LI Jiangbing, SONG Xinhong, LIN Haiyan, ZHANG Dongzhi, LI Xiangyi, XU Yibo, WANG Li, XUE Fuzhong. The influencing factors of ischemic ECG abnormalities in a large health check-up population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 77-81.
[7] SU Ping, YANG Yachao, YANG Yang, JI Jiadong, DAYIMU Alimu, LI Min, XUE Fuzhong, LIU Yanxun. Prediction models on the onset risks of type 2 diabetes among the health management population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 82-86.
[8] SUN Yuanying, YANG Yachao, QU Mingling, CHEN Yanmin, LI Min, WANG Shukang, XUE Fuzhong, LIU Yunxia. A prediction model for metabolic syndrome risk: a study based on the health management cohort [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 87-92.
[9] ZHOU Miao, XIA Tongyao, SUN Ailing, LI Ming, SHEN Zhenwei, BIAN Weiwei, JIANG Zheng, KANG Fengling, LIU Xiaojuan, XUE Fuzhong, LIU Jing. Risk prediction model of chronic kidney disease in health management population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 98-103.
[10] LI Min, WANG Chunxia, XIA Bing, ZHU Qian, SUN Yuanying, WANG Shukang, XUE Fuzhong, JIA Hongying. A stroke prediction model for the health management population [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 93-97.
[11] YU Yuanyuan, WANG Chunxia, SU Ping, SUN Yuanying, XUE Fuzhong, LIU Yanxun. A prediction model to estimate risks of cataract based on health management cohort [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 104-107.
[12] LIU Xiaojuan, JIANG Zheng, KANG Fengling, ZHOU Miao, LIN Weiqiang, XUE Fuzhong. Association between neutrophil count and nonalcoholic fatty liver disease:a prospective cohort study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(6): 119-123.
[13] LI Xiangyi, SUN Xiubin, LU Yulian, SHEN Zhenwei, CHEN Yafei, TANG Fang, XUE Fuzhong. Relationship between uterine fibroid and hyperplasia of mammary glands: a cohort study [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 53-58.
[14] YANG Yang, ZHANG Guang, ZHANG Chengqi, SONG Xinhong, XUE Fuzhong, WANG Ping, WANG Li, LIU Yanxun. A prediction model for type 2 diabetes risks: a cohort study based on health examination [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(9): 69-72.
[15] XIAO Juan, CHEN Qicai, ZHANG Pengpeng, CHEN Lili, CHEN Xiaoxiao, WANG Shumei. Association between serum alanine transaminase with metabolic syndrome and its components based on a longitudinal health check-up study in Dongying City, China [J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(1): 86-91.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright 2018 © Editorial office of Journal of Shandong University (Health Sciences)
Supported by Beijing Magtech Co.Ltd