Non-Alcoholic Fatty Liver Disease Is a Risk Factor for the Development of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus.
Non-Alcoholic Fatty Liver Disease Is a Risk Factor for the Development of Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus.
复制标题
DOI：
10.1371/journal.pone.0142808
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Li N
中科院分区：
文献类型：
--
作者：
Jia G;Di F;Wang Q;Shao J;Gao L;Wang L;Li Q;Li N
非酒精性脂肪肝（NAFLD）在2型糖尿病（T2 DM）患者中普遍存在。糖尿病肾病（DN）也与T2 DM相关。然而，对T2 DM患者中这些疾病之间的相互作用知之甚少。探讨T2 DM患者NAFLD与DN的关系。这项回顾性研究纳入了2006年1月至2014年7月期间观察的患者。T2 DM患者根据NAFLD状态分为两组（伴NAFLD = A组;不伴NAFLD = B组）。比较两组DN的累积发生率及慢性肾脏病（CKD）分期。部分患者检查了肝脏脂肪含量。采用加性互作法分析NAFLD与其他因素和DN的关系。A组累积DN发生率（58.58%）高于B组（37.22%）（P = 0.005）。在两组中，CKD 1期的DN患者数量均大于2-5期的患者数量。肝脏脂肪含量增加与严重和轻度蛋白尿发生率增加以及肾小球滤过率（GFR）降低相关。NAFLD与胰岛素抵抗指数（HOMA-IR）、游离脂肪酸（FFA）、肿瘤坏死因子-α（TNF-α）、网膜素-1（omentin-1）、内脏脂肪面积、同型半胱氨酸（HCY）、血尿酸（UA）呈正相关。NAFLD可能是DN的危险因素。肝脏脂肪含量升高可能与较高的DN负荷相关。
Non-alcoholic fatty liver disease (NAFLD) is prevalent in individuals with type 2 diabetes mellitus (T2DM). Diabetic nephropathy (DN) is also associated with T2DM. However, little is known about the interaction between these conditions in patients with T2DM. To examine the association between NAFLD and DN in patients with T2DM. This retrospective study included patients seen between January 2006 and July 2014.T2DM patients were divided into two groups based on NAFLD status (with NAFLD = group A; without = group B). The cumulative incidence of DN and chronic kidney disease (CKD) staging were compared between the two groups. Liver fat content was examined in some patients. Associations among NAFLD, other factors,and DN were analyzed by the additive interaction method. Cumulative incidence of DN in patients from group A (58.58%) was higher than in group B (37.22%) (P = 0.005). In both groups, the number of DN patients with CKD stage 1 was greater than the number of patients with stages 2–5. Increased liver fat content was associated with increased occurrence of severe and mild albuminuria and decreased glomerular filtration rate (GFR). There were positive correlations between NAFLD and insulin resistance index (HOMA-IR), free fatty acids (FFA), tumor necrosis factor-α (TNF-α), omentin-1, visceral fat area, homocysteine (HCY), and serum uric acid (UA). NAFLD might be a risk factor for DN. Elevated liver fat content could be associated with higher DN burden.