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Kidney Res Clin Pract. 2017 Mar;36(1):48-57. English. Original Article. https://doi.org/10.23876/j.krcp.2017.36.1.48
Yoon CY , Lee M , Kim SU , Lim H , Chang TI , Kee YK , Han SG , Han IM , Kwon YE , Park KS , Lee MJ , Park JT , Han SH , Ahn SH , Kang SW , Yoo TH .
Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea. yoosy0316@yuhs.ac
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Department of Policy Research Affairs, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Internal Medicine, NHIS Medical Center, Ilsan Hospital, Goyang, Korea.
Brain Korea 21 Project for Medical Science, Seoul, Korea.
Severance Biomedical Science Institute, Brain Korea 21 PLUS, Yonsei University, Seoul, Korea.
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.

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