Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter
Background: Changing the term/concept of the non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated fatty liver disease (MAFLD) may broaden the pathological definition that can include chronic renal involvement, and, possibly, changes chronic kidney disease's (CKD's)...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-01-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.788881/full |
| _version_ | 1818754949644812288 |
|---|---|
| author | Luciana Marc Luciana Marc Luciana Marc Adelina Mihaescu Adelina Mihaescu Adelina Mihaescu Raluca Lupusoru Raluca Lupusoru Iulia Grosu Iulia Grosu Iulia Grosu Florica Gadalean Florica Gadalean Florica Gadalean Flaviu Bob Flaviu Bob Flaviu Bob Lazar Chisavu Lazar Chisavu Lazar Chisavu Nicu Olariu Vlad Tucicovschi Bogdan Timar Bogdan Timar Ioan Sporea Romulus Timar Romulus Timar Adalbert Schiller Adalbert Schiller Adalbert Schiller |
| author_facet | Luciana Marc Luciana Marc Luciana Marc Adelina Mihaescu Adelina Mihaescu Adelina Mihaescu Raluca Lupusoru Raluca Lupusoru Iulia Grosu Iulia Grosu Iulia Grosu Florica Gadalean Florica Gadalean Florica Gadalean Flaviu Bob Flaviu Bob Flaviu Bob Lazar Chisavu Lazar Chisavu Lazar Chisavu Nicu Olariu Vlad Tucicovschi Bogdan Timar Bogdan Timar Ioan Sporea Romulus Timar Romulus Timar Adalbert Schiller Adalbert Schiller Adalbert Schiller |
| author_sort | Luciana Marc |
| collection | DOAJ |
| description | Background: Changing the term/concept of the non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated fatty liver disease (MAFLD) may broaden the pathological definition that can include chronic renal involvement, and, possibly, changes chronic kidney disease's (CKD's) epidemiological association with liver disease, because CKD is associated with metabolic disorders and almost all patients with CKD present some form of an atherogenic dyslipidemia. Our study explores the relationship between MAFLD and CKD using Transient Elastography (TE) with a Controlled Attenuated Parameter (CAP).Methods: We evaluated 335 patients with diabetes with MAFLD and with high CKD risk using TE with CAP (FibroScan®). The CKD was defined according to Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines. Logistic regression and stepwise multiple logistic regression were used to evaluate the factors associated with CKD. In addition, a receiver operating characteristic curve (ROC) analysis was used to assess the performance of CAP and TE in predicting CKD and its optimal threshold.Results: The prevalence of CKD in our group was 60.8%. Patients with CKD had higher mean liver stiffness measurements (LSM) and CAP values than those without CKD. We found that hepatic steatosis was a better predictor of CKD than fibrosis. Univariate regression showed that CAP values >353 dB/m were predictive of CKD; while the multivariate regression analysis (after adjustment according to sex, body mass index (BMI), low-density lipoprotein cholesterol (LDLc), and high-density lipoprotein cholesterol (HDLc), and fasting glucose) showed that CAP values >353 dB/m were more strongly associated with the presence of CKD compared to the LSM (fibrosis) values.Conclusion: In patients with MAFLD, CAP-assessed steatosis appears to be a better predictor of CKD compared to LSM-assessed hepatic fibrosis. |
| first_indexed | 2024-12-18T05:31:23Z |
| format | Article |
| id | doaj.art-9fad7fd2b86d4a4785caaae1809e0dbd |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-18T05:31:23Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-9fad7fd2b86d4a4785caaae1809e0dbd2022-12-21T21:19:26ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-01-01810.3389/fmed.2021.788881788881Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation ParameterLuciana Marc0Luciana Marc1Luciana Marc2Adelina Mihaescu3Adelina Mihaescu4Adelina Mihaescu5Raluca Lupusoru6Raluca Lupusoru7Iulia Grosu8Iulia Grosu9Iulia Grosu10Florica Gadalean11Florica Gadalean12Florica Gadalean13Flaviu Bob14Flaviu Bob15Flaviu Bob16Lazar Chisavu17Lazar Chisavu18Lazar Chisavu19Nicu Olariu20Vlad Tucicovschi21Bogdan Timar22Bogdan Timar23Ioan Sporea24Romulus Timar25Romulus Timar26Adalbert Schiller27Adalbert Schiller28Adalbert Schiller29Department of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Functional Sciences, Center for Modeling Biological Systems and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDepartment of Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Diabetes and Nutritional Disease, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDiabetes and Nutritional Disease Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Gastroenterology and Hepatology, Advanced Regional Research Center in Gastroenterology and Hepatology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Diabetes and Nutritional Disease, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaDiabetes and Nutritional Disease Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaDepartment of Internal Medicine II – Division of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaCentre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, RomaniaNephrology Clinic – County Emergency Hospital “Pius Brinzeu”, Timişoara, RomaniaBackground: Changing the term/concept of the non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction associated fatty liver disease (MAFLD) may broaden the pathological definition that can include chronic renal involvement, and, possibly, changes chronic kidney disease's (CKD's) epidemiological association with liver disease, because CKD is associated with metabolic disorders and almost all patients with CKD present some form of an atherogenic dyslipidemia. Our study explores the relationship between MAFLD and CKD using Transient Elastography (TE) with a Controlled Attenuated Parameter (CAP).Methods: We evaluated 335 patients with diabetes with MAFLD and with high CKD risk using TE with CAP (FibroScan®). The CKD was defined according to Kidney Disease Improving Global Outcomes (KDIGO) 2012 guidelines. Logistic regression and stepwise multiple logistic regression were used to evaluate the factors associated with CKD. In addition, a receiver operating characteristic curve (ROC) analysis was used to assess the performance of CAP and TE in predicting CKD and its optimal threshold.Results: The prevalence of CKD in our group was 60.8%. Patients with CKD had higher mean liver stiffness measurements (LSM) and CAP values than those without CKD. We found that hepatic steatosis was a better predictor of CKD than fibrosis. Univariate regression showed that CAP values >353 dB/m were predictive of CKD; while the multivariate regression analysis (after adjustment according to sex, body mass index (BMI), low-density lipoprotein cholesterol (LDLc), and high-density lipoprotein cholesterol (HDLc), and fasting glucose) showed that CAP values >353 dB/m were more strongly associated with the presence of CKD compared to the LSM (fibrosis) values.Conclusion: In patients with MAFLD, CAP-assessed steatosis appears to be a better predictor of CKD compared to LSM-assessed hepatic fibrosis.https://www.frontiersin.org/articles/10.3389/fmed.2021.788881/fullMAFLDNAFLDchronic kidney diseasetransient elastographycontrolled attenuation parameter |
| spellingShingle | Luciana Marc Luciana Marc Luciana Marc Adelina Mihaescu Adelina Mihaescu Adelina Mihaescu Raluca Lupusoru Raluca Lupusoru Iulia Grosu Iulia Grosu Iulia Grosu Florica Gadalean Florica Gadalean Florica Gadalean Flaviu Bob Flaviu Bob Flaviu Bob Lazar Chisavu Lazar Chisavu Lazar Chisavu Nicu Olariu Vlad Tucicovschi Bogdan Timar Bogdan Timar Ioan Sporea Romulus Timar Romulus Timar Adalbert Schiller Adalbert Schiller Adalbert Schiller Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter Frontiers in Medicine MAFLD NAFLD chronic kidney disease transient elastography controlled attenuation parameter |
| title | Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter |
| title_full | Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter |
| title_fullStr | Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter |
| title_full_unstemmed | Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter |
| title_short | Liver Steatosis: Better Predictor of CKD in MAFLD Than Liver Fibrosis as Determined by Transient Elastography With Controlled Attenuation Parameter |
| title_sort | liver steatosis better predictor of ckd in mafld than liver fibrosis as determined by transient elastography with controlled attenuation parameter |
| topic | MAFLD NAFLD chronic kidney disease transient elastography controlled attenuation parameter |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.788881/full |
| work_keys_str_mv | AT lucianamarc liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT lucianamarc liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT lucianamarc liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adelinamihaescu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adelinamihaescu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adelinamihaescu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT ralucalupusoru liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT ralucalupusoru liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT iuliagrosu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT iuliagrosu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT iuliagrosu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT floricagadalean liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT floricagadalean liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT floricagadalean liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT flaviubob liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT flaviubob liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT flaviubob liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT lazarchisavu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT lazarchisavu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT lazarchisavu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT nicuolariu liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT vladtucicovschi liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT bogdantimar liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT bogdantimar liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT ioansporea liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT romulustimar liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT romulustimar liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adalbertschiller liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adalbertschiller liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter AT adalbertschiller liversteatosisbetterpredictorofckdinmafldthanliverfibrosisasdeterminedbytransientelastographywithcontrolledattenuationparameter |