title: Increased prevalence of chronic kidney disease in patients with Type 1 diabetes and non-alcoholic fatty liver.
abstract: OBJECTIVE
  We determined whether non-alcoholic fatty liver is associated with an increased prevalence of chronic kidney disease in Type 1 diabetes.
  
  
  METHODS
  We studied 343 patients with Type 1 diabetes, who had no history of excessive alcohol consumption or other secondary causes of chronic liver disease. Non-alcoholic fatty liver was diagnosed by ultrasonography. Chronic kidney disease was defined as presence of either abnormal albuminuria (i.e., urinary albumin/creatinine ratio ≥ 30 mg/g) or estimated glomerular filtration rate of less than 60 ml min(-1)  1.73 m(-2) .
  
  
  RESULTS
  Compared with those without steatosis, patients with non-alcoholic fatty liver (n = 182) had significantly lower estimated GFR (83.0 ± 27 vs. 93.3 ± 29 ml min(-1)  1.73 m(-2) , P < 0.001) and a greater prevalence of abnormal albuminuria (50.0 vs. 20.5%, P < 0.0001) and chronic kidney disease (54.4 vs. 24.2%, P < 0.0001). Multivariable logistic regression analysis revealed that non-alcoholic fatty liver was associated with an increased risk of either abnormal albuminuria (adjusted odds ratio 2.21, 95% CI 1.2-4.1, P = 0.01) or chronic kidney disease (adjusted odds ratio 1.93, 95% CI 1.1-3.6, P = 0.02), independently of age, gender, smoking status, physical activity, diabetes duration, HbA(1c) , BMI, systolic blood pressure, plasma lipids and use of anti-hypertensive and lipid-lowering medications.
  
  
  CONCLUSIONS
  Our findings demonstrate that ultrasound-diagnosed non-alcoholic fatty liver is associated with a higher prevalence of chronic kidney disease in patients with Type 1 diabetes, independently of several risk factors, including the components of the metabolic syndrome.
authors: Section of Endocrinology and Metabolism, Department of Medicine, University of Verona, Verona, Italy. giovanni.targher@univr.it
authors: G
authors: G
authors: Targher
authors: I
authors: I
authors: Pichiri
authors: G
authors: G
authors: Zoppini
authors: M
authors: M
authors: Trombetta
authors: E
authors: E
authors: Bonora
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D005234:Fatty Liver / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000378:metabolism; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014463:Ultrasonography