Prevalence and Risk Factors of Metabolic Dysfunction-Associated Fatty Liver Disease with Renal Insufficiency in Overweight/Obese Adults

Obes Facts. 2023;16(6):548-558. doi: 10.1159/000533626. Epub 2023 Aug 28.

Abstract

Introduction: The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) with renal insufficiency in recent years and the association between MAFLD and renal insufficiency are not entirely clear, especially in overweight/obesity. The aim of this study was to analyze the prevalence and risk factors of MAFLD with renal insufficiency in overweight/obese adults.

Methods: Individuals who attended checkup at the Second Affiliated Hospital of Xi'an Jiaotong University from 2016 to 2021 were included. The prevalence of MAFLD with renal insufficiency (estimated glomerular filtration rate ≤90 mL/min/1.73 m2) in overweight/obesity was estimated. Propensity score-matched analysis, univariate and multivariate analyses were used to determine the risk factors for MAFLD with renal insufficiency.

Results: From 2016 to 2021, the prevalence of MAFLD in overweight/obesity reached its highest of 44.7% in 2017 and its lowest of 36.9% in 2018; and 33.9% in 2021 and 21.8% in 2019 is the highest and lowest prevalence of MAFLD with renal insufficiency, respectively. MAFLD was more common in men, old individuals, and persons with a higher body mass index (BMI) and was characterized by significant renal insufficiency. MAFLD with renal insufficiency was more common in women, old individuals, and persons with a higher BMI and was characterized by significant metabolic dysfunction and liver fibrosis. Multivariable analysis showed that BMI, uric acid, and fibrosis (evaluated with noninvasive liver fibrosis score [fibrosis-4]) were independent risk factors for MAFLD with renal insufficiency.

Conclusion: The prevalence of MAFLD with renal insufficiency in overweight/obese adults is quite high in the last 5 years. BMI, uric acid, and fibrosis are independent risk factors for MAFLD with renal insufficiency.

Keywords: Fibrosis; Metabolic dysfunction-associated fatty liver disease; Overweight and obesity; Renal insufficiency.

MeSH terms

  • Adult
  • Female
  • Humans
  • Liver Cirrhosis
  • Male
  • Non-alcoholic Fatty Liver Disease* / complications
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Obesity / complications
  • Obesity / epidemiology
  • Overweight / complications
  • Overweight / epidemiology
  • Prevalence
  • Renal Insufficiency* / epidemiology
  • Renal Insufficiency* / etiology
  • Risk Factors
  • Uric Acid

Substances

  • Uric Acid

Grants and funding

This study was supported by the National Key Research and Development Program of China during the 13th Five-Year Plan Period (2018YFC1311504) and the Key Research and Development Program of Shaanxi Province (2022SF-460).