Higher NAFLD fibrosis score is associated with impaired eGFR

Meng-Hsuan Hsieh; Kuan-Ta Wu; Yi-Yu Chen; Jeng-Fu Yang; Wen-Yi Lin; Ning-Chia Chang; Chia-Yi Lin; Chao-Kuan Huang; Chao-Ling Wang; Hung-Yi Chuang; Shu-Ching Lin; Yu-Kuei Hsu; Yi-Shan Tsai; Wan-Long Chuang; Ming-Lung Yu; Chia-Yen Dai

doi:10.1016/j.jfma.2019.07.007

Higher NAFLD fibrosis score is associated with impaired eGFR

J Formos Med Assoc. 2020 Jan;119(1 Pt 3):496-503. doi: 10.1016/j.jfma.2019.07.007. Epub 2019 Jul 25.

Authors

Affiliations

¹ Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC.
² Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
³ Department of Occupational Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Taiwan, ROC.
⁴ Health Examination Center, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan, ROC.
⁵ Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
⁶ Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
⁷ Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
⁸ Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan, ROC. Electronic address: fish6069@gmail.com.
⁹ Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Department of Occupational and Environmental Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Hepatobiliary Section, Department of Internal Medicine, and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC; Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan, ROC. Electronic address: daichiayen@gmail.com.

PMID: 31353118
DOI: 10.1016/j.jfma.2019.07.007

Abstract

Background/purpose: Chronic kidney disease (CKD) has become a worldwide health problem, leading to high morbidity and mortality, and non-alcoholic fatty liver disease (NAFLD) is considered a risk factor for CKD. The aim of this study was to explore the relationship between NAFLD fibrosis score (NFS) and the estimated glomerular filtration rate (eGFR), and identify possible risk factors related to the NFS among Taiwanese subjects.

Methods: Subjects were enrolled from the database of the Department of Preventive Medicine of Kaohsiung Municipal Hsiao-Kang Hospital. The eGFR was calculated according to the Taiwanese Modification of Diet in Renal Disease (TMDRD) equation, and the NFS was employed to evaluate the fibrotic level.

Results: In total, 11,376 subjects were enrolled in this study, with a mean age of 52.0 ± 6.81 years, including 4529 (39.8%) males. A fasting sugar level ≥100 mg/dL (OR = 1.70, 95% CI = 1.52-1.87) and an abnormal waist circumference (OR = 1.81, 95% CI = 1.65-1.99) were significant factors associated with NFS (p < 0.05). Trends of a decreasing TMDRD score and an increasing NFS with increasing age were noted (p < 0.05). The NFS was significantly negatively correlated with the TMDRD score (standard coefficients: -0.067, p < 0.001).

Conclusion: A higher NFS is associated with an impaired eGFR in Taiwanese subjects. Controlling risk factors, especially fasting sugar level and waist circumference, may be useful in preventing NFS deterioration, which is negatively correlated with the eGFR.

Keywords: Estimated glomerular filtration rate; Fasting sugar; NAFLD fibrosis score; Waist circumference.

MeSH terms

Adult
Biomarkers / blood
Female
Glomerular Filtration Rate*
Humans
Liver Cirrhosis / complications
Liver Cirrhosis / diagnosis
Liver Cirrhosis / epidemiology*
Male
Middle Aged
Non-alcoholic Fatty Liver Disease / complications
Non-alcoholic Fatty Liver Disease / epidemiology*
ROC Curve
Renal Insufficiency, Chronic / epidemiology*
Renal Insufficiency, Chronic / etiology
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Taiwan / epidemiology

Substances

Biomarkers