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KMID : 1102220170360010048
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Kidney Research and Clinical Practice
2017 Volume.36 No. 1 p.48 ~ p.57
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Fatty liver associated with metabolic derangement in patients with chronic kidney disease: A controlled attenuation parameter study
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Yoon Chang-Yun
Lee Mi-Sol
Kim Seung-Up
Lim Hyun-Sun
Chang Tae-Ik
Kee Youn-Kyung
Han Seung-Gyu
Han In-Mee
Kwon Young-Eun
Park Kyoung-Sook
Lee Mi-Jung
Park Jung-Tak
Han Seung-Hyeok
Ahn Sang-Hoon
Kang Shin-Wook
Yoo Tae-Hyun
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Abstract
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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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KEYWORD
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Chronic kidney disease, Hepatic steatosis, Metabolic syndrome, Transient elastography
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