MASLD、肝脂肪变性和纤维化与1型糖尿病成人慢性肾病和视网膜病变的患病率相关。

IF 4.6 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Alessandro Mantovani , Mario Luca Morieri , Raffaella Aldigeri , Luisa Palmisano , Maria Masulli , Katia Bonomo , Marco Giorgio Baroni , Efisio Cossu , Flavia Agata Cimini , Gisella Cavallo , Raffaella Buzzetti , Carmen Mignogna , Frida Leonetti , Simonetta Bacci , Roberto Trevisan , Riccardo Maria Pollis , Alessandra Dei Cas , Saula Vigili de Kreutzenberg , Giovanni Targher
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引用次数: 0

摘要

目的:我们研究了伴有或不伴有显著纤维化(通过验证的非侵入性生物标志物评估)的代谢功能障碍相关脂肪变性肝病(MASLD)是否与1型糖尿病(T1DM)患者中流行的慢性肾病(CKD)或糖尿病视网膜病变的风险增加相关。方法:我们进行了一项回顾性多中心横断面研究,涉及1409例T1DM成年门诊患者,计算肝脂肪变性指数(HSI)和纤维化(FIB)-4指数,用于无创检测肝脂肪变性(HSI > 36),是否伴有显著纤维化(FIB-4指数≥1.3或< 1.3)。CKD定义为肾小球滤过率(eGFR) < 60 mL/min/1.73 m2或尿白蛋白/肌酐比值≥3.0 mg/mmol。所有参与者的糖尿病视网膜病变也被记录下来。结果:MASLD合并明显纤维化的患者(n=93) CKD和糖尿病视网膜病变的患病率明显高于无纤维化的MASLD患者(n=578)和无脂肪变性的患者(n=738)。在调整性别、糖尿病病程、糖化血红蛋白、高血压和使用降压或降脂药物后,SLD和显著纤维化患者比无脂肪变性的患者有更高的流行CKD风险(调整优势比1.76,95%可信区间1.05-2.96)。无纤维化的MASLD患者比无脂肪变性的患者有更高的视网膜病变风险(校正优势比1.49,95% CI 1.13-1.46)。结论:这是最大的横断面研究,表明MASLD伴或不伴显著纤维化与T1DM成人流行CKD和视网膜病变的风险增加相关,独立于潜在的混杂因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MASLD, hepatic steatosis and fibrosis are associated with the prevalence of chronic kidney disease and retinopathy in adults with type 1 diabetes mellitus

Aim

We examined whether metabolic dysfunction-associated steatotic liver disease (MASLD) with or without significant fibrosis (assessed by validated non-invasive biomarkers) was associated with an increased risk of prevalent chronic kidney disease (CKD) or diabetic retinopathy in people with type 1 diabetes mellitus (T1DM).

Methods

We performed a retrospective multicenter cross-sectional study involving 1,409 adult outpatients with T1DM, in whom hepatic steatosis index (HSI) and fibrosis (FIB)-4 index were calculated for non-invasively detecting hepatic steatosis (defined by HSI > 36), with or without coexisting significant fibrosis (FIB-4 index ≥ 1.3 or < 1.3). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or urine albumin/creatinine ratio ≥ 3.0 mg/mmol. The presence of diabetic retinopathy was also recorded in all participants.

Results

Patients with MASLD and significant fibrosis (n = 93) had a remarkably higher prevalence of CKD and diabetic retinopathy than their counterparts with MASLD without fibrosis (n = 578) and those without steatosis (n = 738). After adjustment for sex, diabetes duration, hemoglobin A1c, hypertension, and use of antihypertensive or lipid-lowering medications, patients with SLD and significant fibrosis had a higher risk of prevalent CKD (adjusted-odds ratio 1.76, 95 % confidence interval 1.05–2.96) than those without steatosis. Patients with MASLD without fibrosis had a higher risk of prevalent retinopathy (adjusted-odds ratio 1.49, 95 % CI 1.13–1.46) than those without steatosis.

Conclusion

This is the largest cross-sectional study showing that MASLD with and without coexisting significant fibrosis was associated, independently of potential confounders, with an increased risk of prevalent CKD and retinopathy in adults with T1DM.

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来源期刊
Diabetes & metabolism
Diabetes & metabolism 医学-内分泌学与代谢
CiteScore
12.00
自引率
4.20%
发文量
86
审稿时长
13 days
期刊介绍: A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.
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