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Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes

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Author(s)
Eugene Han Yongin Cho Kyung-Won Kim Yong-Ho Lee Eun Seok Kang Bong-Soo Cha Byung-Wan Lee
Keimyung Author(s)
Han, Eu Gene
Department
Dept. of Internal Medicine (내과학)
Journal Title
Medicine
Issued Date
2020
Volume
99
Issue
33
Keyword
albuminuriahepatic fibrosisproteinuriatype 2 diabetes mellitusdiabetic kidney disease
Abstract
The association between non-alcoholic fatty liver disease (NAFLD) and diabetic kidney disease assessed using either albuminuria or proteinuria remains controversial. This study aimed to investigate the association between hepatic steatosis or fibrosis and albuminuria or proteinuria in Korean patients with type 2 diabetes mellitus (T2D).

We enrolled 1108 patients with T2D and categorized as 3 groups; non-proteinuria (NP), isolated non-albumin proteinuria (iNAP), and albuminuria. Urinary albumin and protein levels were assessed as urinary albumin-to-creatinine ratio (uACR) and urinary protein-to-creatinine ratio (uPCR), respectively. Hepatic steatosis and fibrotic burden were assessed using the NAFLD liver fat score, Fibrosis-4 calculator (FIB-4) index, and NAFLD fibrosis score (NFS).

The prevalence of significant steatosis was similar among groups (NP: 74.6% vs iNAP: 70.3% vs albuminuria: 79.9%, P = .085). The prevalence of significant fibrosis was significantly higher in the iNAP (18.7%) and albuminuria (16.5%) groups than in the NP group (9.5%, P = .001). Both uPCR and uACR showed a correlation with NFS (uPCR: r = 0.123, P < .001; uACR: r = 0.064, P = .033). In multivariate logistic regression analysis, uPCR ≥150 mg/g was found to have a stronger association with hepatic fibrosis than uACR ≥30 mg/g (adjusted odds ratio 1.55 [95% CI 1.03-2.33] vs adjusted odds ratio 1.16 [95% CI, 0.72-1.87]).

In conclusion, patients with iNAP and albuminuria had a higher prevalence of hepatic fibrosis than those without proteinuria. Total proteinuria was associated with advanced liver fibrosis, whereas albuminuria was related to hepatic steatosis.
Keimyung Author(s)(Kor)
한유진
Publisher
School of Medicine (의과대학)
Citation
Eugene Han et al. (2020). Hepatic fibrosis is associated with total proteinuria in Korean patients with type 2 diabetes. Medicine, 99(33), e21038. doi: 10.1097/MD.0000000000021038
Type
Article
ISSN
1536-5964
Source
https://journals.lww.com/md-journal/Fulltext/2020/08140/Hepatic_fibrosis_is_associated_with_total.12.aspx
DOI
10.1097/MD.0000000000021038
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43243
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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