Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus
Ketone body production, an alternative fuel upon low glucose availability, reduces hepatic fat accumulation. However, its clinical implications have not been established in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the association between spontaneous fasting ketonuria a...
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MDPI AG
2021-09-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/10/3400 |
| _version_ | 1797513577596190720 |
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| author | Kiyoung Lim Minkyu Kang Junggil Park |
| author_facet | Kiyoung Lim Minkyu Kang Junggil Park |
| author_sort | Kiyoung Lim |
| collection | DOAJ |
| description | Ketone body production, an alternative fuel upon low glucose availability, reduces hepatic fat accumulation. However, its clinical implications have not been established in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the association between spontaneous fasting ketonuria and liver fibrosis in patients with NAFLD without prediabetes and diabetes mellitus (DM). A total of 6202 patients with ultrasound confirmed NAFLD without prediabetes and DM were enrolled in the study. Using low cut off values of NAFLD fibrosis score (NFS) and fibrosis-4, liver fibrosis was defined as an intermediate–high probability of advanced liver fibrosis. Of the 6202 NAFLD patients, 360 (5.8%) had ketonuria. Compared to the patients without ketonuria, patients with ketonuria were younger (41.1 vs. 44.6 years, <i>p</i> < 0.001), had lower levels of glucose (87.2 vs. 91.0 mg/dL, <i>p</i> < 0.001), and homeostatic model assessment for insulin resistance (1.0 vs. 1.5, <i>p</i> < 0.001). The presence of ketonuria had an inverse association with liver fibrosis, assessed using both NFS (final adjusted odds ratio [aOR], 0.67; 95% confidence interval [CI], 0.45–1.01) and fibrosis-4 (aOR, 0.58; 95% CI, 0.40–0.84). The presence of ketonuria in NAFLD patients without prediabetes and DM may have favorable metabolic effects compared to the absence of ketonuria, independent of traditional metabolic factors. |
| first_indexed | 2024-03-10T06:18:33Z |
| format | Article |
| id | doaj.art-c794c646025840b8b3960abadb9102d5 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T06:18:33Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-c794c646025840b8b3960abadb9102d52023-11-22T19:28:01ZengMDPI AGNutrients2072-66432021-09-011310340010.3390/nu13103400Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes MellitusKiyoung Lim0Minkyu Kang1Junggil Park2Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, KoreaDepartment of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, KoreaDepartment of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, KoreaKetone body production, an alternative fuel upon low glucose availability, reduces hepatic fat accumulation. However, its clinical implications have not been established in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the association between spontaneous fasting ketonuria and liver fibrosis in patients with NAFLD without prediabetes and diabetes mellitus (DM). A total of 6202 patients with ultrasound confirmed NAFLD without prediabetes and DM were enrolled in the study. Using low cut off values of NAFLD fibrosis score (NFS) and fibrosis-4, liver fibrosis was defined as an intermediate–high probability of advanced liver fibrosis. Of the 6202 NAFLD patients, 360 (5.8%) had ketonuria. Compared to the patients without ketonuria, patients with ketonuria were younger (41.1 vs. 44.6 years, <i>p</i> < 0.001), had lower levels of glucose (87.2 vs. 91.0 mg/dL, <i>p</i> < 0.001), and homeostatic model assessment for insulin resistance (1.0 vs. 1.5, <i>p</i> < 0.001). The presence of ketonuria had an inverse association with liver fibrosis, assessed using both NFS (final adjusted odds ratio [aOR], 0.67; 95% confidence interval [CI], 0.45–1.01) and fibrosis-4 (aOR, 0.58; 95% CI, 0.40–0.84). The presence of ketonuria in NAFLD patients without prediabetes and DM may have favorable metabolic effects compared to the absence of ketonuria, independent of traditional metabolic factors.https://www.mdpi.com/2072-6643/13/10/3400diabetes mellitusketone bodiesnonalcoholic fatty liver diseasefibrosis |
| spellingShingle | Kiyoung Lim Minkyu Kang Junggil Park Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus Nutrients diabetes mellitus ketone bodies nonalcoholic fatty liver disease fibrosis |
| title | Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus |
| title_full | Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus |
| title_fullStr | Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus |
| title_full_unstemmed | Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus |
| title_short | Association between Fasting Ketonuria and Advanced Liver Fibrosis in Non-Alcoholic Fatty Liver Disease Patients without Prediabetes and Diabetes Mellitus |
| title_sort | association between fasting ketonuria and advanced liver fibrosis in non alcoholic fatty liver disease patients without prediabetes and diabetes mellitus |
| topic | diabetes mellitus ketone bodies nonalcoholic fatty liver disease fibrosis |
| url | https://www.mdpi.com/2072-6643/13/10/3400 |
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