The Associations Between Nonalcoholic Fatty Liver Disease And Diabetic Nephropathy In Elderly Patients With Type2Diabetes

ObjectiveTo investigate the associations between nonalcoholic fatty liver disease(NAFLD)and diabetic nephropathy in a cohort of elderly type2diabetes mellitus(T2DM)individuals using a cross-sectional design.MethodsAll the object were selected from the inpatients of the First Affiliated Hospital ofZhengzhou University from January2012to January2014,and the object were60years old or older from department of endocrinology and department ofendocrinology in gerontology. Four hundred patients were investigated respectively.Prevalences of type2diabetic nephropathy were assessed in400type2diabeticpatients.T2DM with NAFLD group（NAFLD group，n=200）and T2DM withoutNAFLD group（without NAFLD group，n=200）. Following clinical data werecollected, duration of diabetes, smoking history, drinking history,history of drug;andmeasuring height and weight, BMI=weight (kg)/height (m)2;measuring SBP andDBP; TC,TG, LDL-C, HDL-C, FBG,ALT, AST, HbA1C;24h urinary albumin excretion rate was measured as indicators of early diabetic nephropathy,andultrasound was used to diagnose NAFLD. The relevant factors of two groups wereanalysed by T test and chi-square test.univariate and multivariate logistic regressionanalysis after adusting confounding factors were use to assess the association betweenNAFLD and diabetic nephropathy in elderly patients with T2DM.Results1．The general data analysis, BMI, SBP, DBP, FPG, HbA1C, TG, HDL-C, ALT,AST, UAER of NAFLD group is higher than those without NAFLD (P＜0.05,differences are statistically significant), while gender, age, duration, smoking history,TC, LDL-C between the two groups was not statistically significant(P＞0.05).Theprevalence of diabetic nephropathy in NAFLD group is higher than without NAFLDgroup (P＜0.01, differences are statistically significant)(shown in Table3.1).2．Univariate logistic showed BMI, SBP, FPG, HbA1C, TG, LDL-C, ALT, AST,NAFLD is a risk factor for UAER (P＜0.01, differences are statistically significant)（shown in Table3.2）.Associated risk factors were entered into multi-factor Logisticregression analysis, NAFLD is associated with UAER (P＜0.05, OR=1.10,95%CI,1.08～1.12（)shown in Table3.3）. And BMI,SBP,HbA1c,TG,LDL-C werealso related to UAER in elderly patients with T2DM (P＜0.01）（shown in Table3.4）。Conclusions1．The prevelence of diabetic nephropathy in elderly type2diabetes mellituswith NAFLD is significantly higher than those without NAFLD.2．Non-alcoholic fatty liver disease is probably an independent risk factor fordiabetic nephropathy in elderly patients with type2diabetes mellitus.3．BMI,SBP,HbA1c,TG,LDL-C are probably an independent risk factor for diabetic nephropathy in elderly patients with type2diabetes mellitus.