通过瞬时弹性成像评估慢性肾病和2型糖尿病与代谢功能障碍相关的脂肪变性肝病和肝纤维化的关联：基于NHANES 2017-2020的横断面研究

IF 7.4 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes research and clinical practice Pub Date : 2025-08-11 DOI:10.1016/j.diabres.2025.112418

Ting Xu , Weifang Zhu

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引用次数: 0

摘要

目的：本研究旨在阐明慢性肾脏疾病（CKD）和2型糖尿病（T2DM）与代谢功能障碍相关脂肪变性肝病（MASLD）和肝纤维化（LF）患病率风险的单独和联合关联。方法本横断面研究包括2017年至2020年3月参加国家健康与营养检查调查（NHANES）的6035名美国成年人。肝脂肪变性（HS）和肝脂肪变性（LF）采用瞬时弹性成像诊断。通过逻辑回归分析检查疾病状态与结果的联系。结果smasld和LF患病率分别为27%和16%。在不排除合并症的情况下，CKD和T2DM均与MASLD和LF的风险增加相关(CKD与非CKD: MASLD的比值比(OR) = 1.266 [1.024-1.566]， LF的比值比(OR) = 1.817 [1.518-2.174]；T2DM与非T2DM: MASLD OR = 2.418 [1.937-3.017], LF OR = 2.163[1.658-2.821])。在排除合并症病例并将无CKD或T2DM的个体作为参照组后，单纯CKD与MASLD无显著相关性，T2DM + CKD的MASLD风险与单纯T2DM相当，但LF风险更高（or = 3.495[2.671-4.574]），超过单纯T2DM组（or = 1.662[1.126-2.451]）或单纯CKD组（or = 1.384[1.068-1.794]）。亚组分析证实，T2DM + CKD合并的风险在所有阶层均升高。结论T2DM合并CKD与LF风险增加相关，而单独T2DM与MASLD风险增加相关。

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Association of chronic kidney disease and type 2 diabetes mellitus with metabolic dysfunction-associated steatotic liver disease and liver fibrosis assessed by transient elastography: a cross-sectional study based on NHANES 2017–2020

Aims

The study endeavors to elucidate the separate and combined associations of chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) with the prevalence risks of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis (LF).

Methods

This cross-sectional study encompassed 6,035 American adults in the National Health and Nutrition Examination Survey (NHANES) from 2017 to March 2020. Hepatic steatosis (HS) and LF were diagnosed using transient elastography. The link of disease status to outcomes was examined via logistic regression analyses.

Results

MASLD and LF prevalences were 27 % and 16 %, respectively. When comorbidities were not excluded, both CKD and T2DM were related to increased risk of MASLD and LF (CKD vs. non-CKD: MASLD odds ratio (OR) = 1.266 [1.024–1.566], LF OR = 1.817 [1.518–2.174]; T2DM vs. non-T2DM: MASLD OR = 2.418 [1.937–3.017], LF OR = 2.163 [1.658–2.821]). After excluding comorbid cases and using individuals without CKD or T2DM as the reference group, CKD-only showed no significant association with MASLD, T2DM + CKD had comparable MASLD risk to T2DM-alone but higher LF risk (OR = 3.495 [2.671–4.574]), exceeding T2DM-only (1.662 [1.126–2.451]) or CKD-only (1.384 [1.068–1.794]) groups. Subgroup analyses confirmed elevated risks across all strata for combined T2DM + CKD.

Conclusion

T2DM with CKD is associated with increased LF risk, while T2DM alone is linked to higher MASLD risk.

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来源期刊

Diabetes research and clinical practice 医学-内分泌学与代谢

CiteScore

10.30

自引率

3.90%

发文量

862

审稿时长

32 days

期刊介绍： Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.