title: Liver steatosis and the risk of albuminuria: the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  To measure association between hepatic fat and albuminuria (an early marker of renal injury) in individuals without diabetes or hypertension.
  
  
  METHODS
  2,281 individuals in the Multi-Ethnic Study of Atherosclerosis without diabetes or hypertension, renal disease, or excess alcohol consumption underwent computed tomography (CT) for assessment of liver attenuation (marker of hepatic lipid content) and urinalysis (for albuminuria) at initial study visit, with assessment of incident and prevalent albuminuria by logistic regression in follow-up.
  
  
  RESULTS
  After adjustment for age, gender, race, smoking, blood pressure, insulin resistance, and body mass index, individuals with less liver fat (higher liver CT attenuation) had a lower probability of having albuminuria at Exam 1 (OR per 10 unit increase in attenuation 0.77, 95 % CI 0.61-0.97, P = 0.02). At median 9.3 years follow-up, albuminuria was identified in 129 individuals were (5.8 %). In fully adjusted models (with age, smoking, body mass index, blood pressure, diabetes and hypertension as time-dependent covariates), lower liver attenuation (greater liver fat) was associated with higher risk of incident albuminuria (OR 0.79, 95 % CI 0.66-0.94, P = 0.008).
  
  
  CONCLUSIONS
  Hepatic attenuation is associated with prevalent and incident albuminuria, an early, potent risk factor for renal risk in a population not clearly at risk for future renal failure.
authors.affiliation: Department of Cardiology and Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Suite 454-East, Boston, MA, 02215, USA. rshah1@bidmc.harvard.edu.
authors.forename: Ravi V
authors.initials: RV
authors.lastname: Shah
authors.affiliation: Department of Family and Preventative Medicine, University of California-San Diego, San Diego, CA, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.affiliation: Cardiology Division, Johns Hopkins Medical Institute, Baltimore, MD, USA.
authors.forename: Joao A C
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Department of Cardiology and Medicine, Brown University, Providence, RI, USA.
authors.forename: Siddique A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Department of Family and Preventative Medicine, University of California-San Diego, San Diego, CA, USA.
authors.forename: Morgana
authors.initials: M
authors.lastname: Mongraw-Chaffin
authors.affiliation: Non-Invasive Cardiovascular Imaging, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Jerosch-Herold
authors.affiliation: Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.affiliation: Department of Cardiology and Medicine, University of California-Los Angeles, Los Angeles, CA, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.affiliation: Cardiovascular Medicine Division, Department of Medicine, Nuclear Medicine and Cardiothoracic Imaging Divisions, Department of Radiology, University of Michigan, 1338 Cardiovascular Center, Ann Arbor, MI, USA. vlmurthy@med.umich.edu.
authors.forename: Venkatesh L
authors.initials: VL
authors.lastname: Murthy
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D003404:Creatinine / Q000378:metabolism; D005006:Ethnicity; D005234:Fatty Liver / Q000150:complications / Q000175:diagnosis / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009391:Nephelometry and Turbidimetry; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology
chemical_list: D003404:Creatinine
keywords: Albuminuria; Hepatic steatosis; Inflammation; Obesity