Research On The Correlation Between Nonalcoholic Fatty Liver Disease And Glomerular Filtration Rate

Background and Objective:Nonalcoholic fatty liver disease(NAFLD)is a metabolic stress liver injury,which is closely related to insulin resistance(IR)and genetic susceptibility.Its pathological changes are similar to that of alcoholic liver disease(ALD).But the patients do not have excessive drinking history.The disease spectrum includes nonalcoholic simple fatty liver(NAFL),nonalcoholic steatohepatitis(NASH),liver cirrhosis related to NASH and hepatocellular carcinoma.The total prevalence of NAFLD among global adults is 25.24%.Several population-based epidemiological studies show that,in China,the total prevalence of NASH among adults is 15%(6.3%-27.0%).The prevalence among children and teenagers is 1.3%.With the popularity of obesity and metabolic syndrome worldwide,NAFLD grow rapidly and showed a trend of low age.Nonalcoholic fatty liver disease has become the main cause of chronic liver disease.Compared to ordinary people with similar age and same sex,NAFLD increases the risk of end-stage liver disease,hepatocellular carcinoma(HCC),and all liver-related causes of death.In addition to the effect on liver itself,NAFLD is also a risk factor for many extrahepatic diseases,such as cardiovascular disease(Cardiovascular,Disease,CVD),chronic kidney disease(Chronic kidney disease,CKD),colorectal cancer,endocrine diseases(including type 2 diabetes mellitus(T2DM)and thyroid dysfunction)and osteoporosis.Kidney disease is a major worldwide problem of clinical and public health.Chronic kidney disease(CKD)is characterized by high prevalence,low awareness,poor prognosis and high medical cost.It is another serious disease that endangers human health after cardio-cerebrovascular diseases,diabetes and malignancies.Many studies have confirmed that NAFLD is an independent risk factor for CKD,but early CKD is also associated with high morbidity and mortality.Earlier detection of abnormal glomerular filtration rate(GFR)becomes significant.Therefore,the purpose of this study is to explore the effect of NAFLD on early glomerular filtration rate by studying the correlation between NAFLD and glomerular filtration rate(GFR)of general physical examination population.We hope to intervene in the related risk factors at the early stage of CKD to reduce the occurrence of CKD,and to provide research targets for the prevention and treatment of CKD.At the same time,because of the NAFLD's asymptomatic and the lack of specific treatment methods,we don't have enough understanding of NAFLD and lack enough attention.We hope that we can enhance our understanding of NAFLD through this research,and pay more attention to NAFLD,and intervene early.Objects and Methods1.Research objects:This study retrospectively selected the ordinary people under 70 years old that participated in annual physical examinations and got whole examination results from 2017-03-01 to 2017-03-15 in health management center of Southern Hospital affiliated to Southern Medical University.At last,157 NAFLD patients and 661 patients without NAFLD were studied.2.Statistics method:SPSS22.0 software is used for analysis.The data of the approximate normal distribution are expressed as mean ± standard deviation(X±s).The data of non-normal distribution are expressed by M(Q1-Q3).Enumeration data are expressed by case number and percentage(%).Two groups of approximate normal distribution data were compared by independent sample T test.Two groups of non-normal distribution data are compared by Wilcoxon nonparametric sign rank test.Chi-square test is used for comparison of rates.Two groups of data are paired by the propensity score matching(PSM)method.With the removal of the influence of confounding factors,the difference of P<0.05 was statistically significant.ResultsThe glomerular filtration rate(GFR)of the NAFLD group was lower than that of the non-NAFLD group(99.69(89.72-108.68)mL/min/1.73m2 vs.106.05(95.43-115.86)mL/min/1.73m2.The difference between the two groups was statistically significant(P<0.001).After adjusting for gender,age,metabolic syndrome,BMI,waist circumference,fasting blood glucose,blood pressure,blood lipid and uric acid,the difference in GFR between NAFLD group and NAFLD group is still significant(99.45(89.72-108.77)mL/min/1.73m2 vs.103.76(92.61-113.14)mL/min/1.73m2,P=0.035).ConclusionsThe presence of non-alcoholic fatty liver disease(NAFLD)is associated with the decrease in glomerular filtration rate(GFR)and NAFLD is an independent risk factor of the decrease in glomerular filtration rate(GFR).This association is reflected before the presence of CKD.