Non-alcoholic fatty liver disease, achievement of metabolic goals with incident cardiovascular disease and eGFR-based chronic kidney disease in patients with prediabetes and diabetes
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Metabolism. Sep 10, 2021: 154874. doi: 10.1016 / j.metabol.2021.154874. Online ahead of print.
OBJECTIVES / HYPOTHESIS: We sought to assess the effect of NAFLD on the risk of incident cardiovascular disease (CVD) and chronic renal failure (CRF) based on estimated glomerular filtration rate (eGFR), and to test further the joint effects and interactions between NAFLD status and the individual metabolic component, as well as the complete achievement of the metabolic goal “ABC”, on the risk of CVD and CRF in 101,296 patients with prediabetes or diabetes from a prospective cohort study.
METHODS: We conducted the study based on the China Cardiometabolic Disease and Cancer Cohort (4C), a large-scale population-based prospective cohort. After ruling out alcohol abuse and other causes of liver disease, we used the Hepatic Fatty Disease Index (FLI) â¥ 60 as a proxy for NAFLD and stratified the likelihood of fibrosis by the aspartate transaminase / alanine ratio transaminase (AAR) with cutoffs of 0.8 and 1.4. The metabolic goal “ABC” was defined as subjects who had an HbA1c
RESULTS: Multivariate adjusted risk ratios (HR) were 1.15 (95% confidence interval (CI), 1.05-1.27) for cardiovascular events and 1.33 (95% CI, 1.20-1.48) for CRF in NAFLD patients, compared to participants without NAFLD. . Among NAFLD patients, compared to people with low RAA (
CONCLUSIONS: NAFLD was associated with CVD and incident CKD in patients with prediabetes or diabetes. Such associations have been substantially modified by the complete achievement of the metabolic goal.
PMID: 34517014 | DOI: 10.1016 / j.metabol.2021.154874