title: Association between non-invasively diagnosed hepatic steatosis and chronic kidney disease in Chinese adults on their health check-up.
abstract: OBJECTIVE
  To explore the association between chronic kidney disease (CKD), graded by the estimated glomerular filtration rate (eGFR), and non-alcoholic fatty liver disease (NAFLD) using controlled attenuation parameter (CAP) and fatty liver index (FLI) values in Chinese adults undergoing routine health examinations.
  
  
  METHODS
  A total of 731 adult participants without diabetes mellitus or significant alcohol consumption who underwent routine health examinations were included. Their eGFR, CAP, FLI and abdominal ultrasonography results were assessed.
  
  
  RESULTS
  The prevalence of ultrasound-diagnosed NAFLD and CKD (eGFR <60 mL/min per 1.73 m2) was 36.1% and 6.6%, respectively. CKD was more common in NAFLD patients than in those without (10.6% vs 4.3%, P < 0.001). The CAP and FLI values were significantly higher in the NAFLD group than in those without, but the change in the eGFR was negligible between the two groups. eGFR was negatively correlated with CAP (r = -0.189, P = 0.003) and FLI values (r = -0.130, P = 0.045). Moreover, eGFR was significantly lower in participants with CAP >292 dBm or FLI ≥60 than in those with CAP <238 dBm or FLI <30, respectively (both P < 0.05). The CAP value (odds ratio [OR] 1.099, 95% confidence interval [CI] 1.091-1.108, P = 0.021) was an independent risk factor for CKD.
  
  
  CONCLUSIONS
  A diagnosis of hepatic steatosis is related to an increased risk of CKD among non-alcoholic and non-diabetic Chinese adults regardless of whether the diagnosis was acquired via ultrasound, CAP or FLI. Increased hepatic lipid content may contribute to CKD development.
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jing
authors.identifier: http://orcid.org/0000-0002-6654-1745
authors.initials: J
authors.lastname: Zeng
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Sun
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Wan Lu
authors.initials: WL
authors.lastname: Sun
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Guang Yu
authors.initials: GY
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Shi Yan
authors.initials: SY
authors.lastname: Yan
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zheng Jie
authors.initials: ZJ
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Yuan Wen
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Gastroenterology, Center for Fatty Liver, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Jian Gao
authors.initials: JG
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005919:Glomerular Filtration Rate; D006801:Humans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D014463:Ultrasonography; D055815:Young Adult
keywords: chronic kidney disease; controlled attenuation parameter; estimated glomerular filtration rate; fatty liver index; non-alcoholic fatty liver disease