title: Non-Alcoholic Fatty Liver Disease Is a Risk Factor for the Development of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) is prevalent in individuals with type 2 diabetes mellitus (T2DM). Diabetic nephropathy (DN) is also associated with T2DM. However, little is known about the interaction between these conditions in patients with T2DM.
  
  
  OBJECTIVE
  To examine the association between NAFLD and DN in patients with T2DM.
  
  
  METHODS
  This retrospective study included patients seen between January 2006 and July 2014.T2DM patients were divided into two groups based on NAFLD status (with NAFLD = group A; without = group B). The cumulative incidence of DN and chronic kidney disease (CKD) staging were compared between the two groups. Liver fat content was examined in some patients. Associations among NAFLD, other factors,and DN were analyzed by the additive interaction method.
  
  
  RESULTS
  Cumulative incidence of DN in patients from group A (58.58%) was higher than in group B (37.22%) (P = 0.005). In both groups, the number of DN patients with CKD stage 1 was greater than the number of patients with stages 2-5. Increased liver fat content was associated with increased occurrence of severe and mild albuminuria and decreased glomerular filtration rate (GFR). There were positive correlations between NAFLD and insulin resistance index (HOMA-IR), free fatty acids (FFA), tumor necrosis factor-α (TNF-α), omentin-1, visceral fat area, homocysteine (HCY), and serum uric acid (UA).
  
  
  CONCLUSIONS
  NAFLD might be a risk factor for DN. Elevated liver fat content could be associated with higher DN burden.
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin Key Laboratory of Artificial Cells (TKL), Tianjin, China.
authors.forename: Guoyu
authors.initials: G
authors.lastname: Jia
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Fusheng
authors.initials: F
authors.lastname: Di
authors.affiliation: Department of Hemodialysis, The Fourth Central Hospital of Tianjin, Tianjin, China.
authors.forename: Qipeng
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Jinshuang
authors.initials: J
authors.lastname: Shao
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Endocrinology and Metabolism, The Third Central Hospital of Tianjin, Tianjin, China.
authors.forename: Nali
authors.initials: N
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis; D015897:Comorbidity; D016207:Cytokines / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000378:metabolism / Q000503:physiopathology* / Q000517:prevention & control; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D005260:Female; D058851:GPI-Linked Proteins / Q000378:metabolism; D005919:Glomerular Filtration Rate; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D037102:Lectins / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000378:metabolism / Q000503:physiopathology*; D012189:Retrospective Studies; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014527:Uric Acid / Q000097:blood
chemical_list: D016207:Cytokines; D005230:Fatty Acids, Nonesterified; D058851:GPI-Linked Proteins; C432397:ITLN1 protein, human; D037102:Lectins; D014409:Tumor Necrosis Factor-alpha; D006710:Homocysteine; D014527:Uric Acid