title: Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study.
abstract: BACKGROUND
  Hepatic steatosis measured with controlled attenuation parameter (CAP) using transient elastography predicts metabolic syndrome in the general population. We investigated whether CAP predicted metabolic syndrome in chronic kidney disease patients.
  
  
  METHODS
  CAP was measured with transient elastography in 465 predialysis chronic kidney disease patients (mean age, 57.5 years).
  
  
  RESULTS
  The median CAP value was 239 (202-274) dB/m. In 195 (41.9%) patients with metabolic syndrome, diabetes mellitus was more prevalent (105 [53.8%] vs. 71 [26.3%],P< 0.001), with significantly increased urine albumin-to-creatinine ratio (184 [38-706] vs. 56 [16-408] mg/g Cr,P= 0.003), high sensitivity C-reactive protein levels (5.4 [1.4-28.2] vs. 1.7 [0.6-9.9] mg/L,P< 0.001), and CAP (248 [210-302] vs. 226 [196-259] dB/m,P< 0.001). In multiple linear regression analysis, CAP was independently related to body mass index (β = 0.742,P< 0.001), triglyceride levels (β = 2.034,P< 0.001), estimated glomerular filtration rate (β = 0.316,P= 0.001), serum albumin (β = 1.386,P< 0.001), alanine aminotransferase (β = 0.064,P= 0.029), and total bilirubin (β = -0.881,P= 0.009). In multiple logistic regression analysis, increased CAP was independently associated with increased metabolic syndrome risk (per 10 dB/m increase; odds ratio, 1.093; 95% confidence interval, 1.009-1.183;P= 0.029) even after adjusting for multiple confounding factors.
  
  
  CONCLUSIONS
  Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Chang-Yun
authors.initials: CY
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Misol
authors.initials: M
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.affiliation: Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
authors.forename: Hyunsun
authors.initials: H
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, NHIS Medical Center, Ilsan Hospital, Goyang, Korea.
authors.forename: Tae Ik
authors.initials: TI
authors.lastname: Chang
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Youn Kyung
authors.initials: YK
authors.lastname: Kee
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Seung Gyu
authors.initials: SG
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: In Mee
authors.initials: IM
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Kwon
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Kyoung Sook
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Jung Tak
authors.initials: JT
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Seung Hyeok
authors.initials: SH
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea; Brain Korea 21 Project for Medical Science, Seoul, Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea; Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Korea.
authors.forename: Shin-Wook
authors.initials: SW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yoo
keywords: Chronic kidney disease; Hepatic steatosis; Metabolic syndrome; Transient elastography