Kidney Res Clin Pract.
2017 Mar;36(1):48-57. 10.23876/j.krcp.2017.36.1.48.
Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study
- Affiliations
-
- 1Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea. yoosy0316@yuhs.ac
- 2Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
- 3Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
- 4Department of Internal Medicine, NHIS Medical Center, Ilsan Hospital, Goyang, Korea.
- 5Brain Korea 21 Project for Medical Science, Seoul, Korea.
- 6Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Korea.
- KMID: 2409389
- DOI: http://doi.org/10.23876/j.krcp.2017.36.1.48
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.
CONCLUSION
Increased CAP measured with transient elastography significantly correlated with and could predict increased metabolic syndrome risk in chronic kidney disease patients.
MeSH Terms
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Alanine Transaminase
Bilirubin
Body Mass Index
C-Reactive Protein
Diabetes Mellitus
Elasticity Imaging Techniques
Fatty Liver*
Glomerular Filtration Rate
Humans
Linear Models
Logistic Models
Odds Ratio
Renal Insufficiency, Chronic*
Serum Albumin
Triglycerides
Alanine Transaminase
Bilirubin
C-Reactive Protein
Serum Albumin
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