Early Identification Of Impaired Renal Function In The Nonalcoholic Fatty Liver Patients

Objective: To identify early renal damage in the nonalcoholic fatty liver disease(NAFLD) patients with nonhypertension,nondiabetes and without history of nephropathy.Method: 169 patients with nonhypertension,nondiabetes and without history of nephropathy were collected from December 2014 to January 2015 in the clinic and medical center of our hospital between the age from 20 to 60.104 subjects were in the nonalcoholic fatty liver disease group.31 subjects were in the simple obesity control group(SO).34 subjects were in the healthy control group(HC). Additionally, according to the combination of the metabolic syndrome groups divided into four subgroups, namely, one component of the metabolic syndrome group(n=10),two components of the metabolic syndrome goup(n=43),three components of the metabolic syndrome group(n=37) and four components of the metabolic syndrome group(n=14).All subjects were recorded general human body data(name, age, height, weight and other basic information),and collected sereum and morning urine,detected biochemical indicators(AST、ALT、γ-GGT、serum creatinine、Cystatin c),metabolic markers(total cholesterol、triglyceride、high density lipoprotein、low densith lipoprotein、uric acid、fasting blood glucose, two hours postprandial blood glucose and fasting insulin) and early renal damage makers(urinary albumin / creatinine ratio and β2-microglobulin). Besides we calculated the glomerular filtration rate by serum creatinine and age..After Collecting all the information, we took the above indexes into comparison.Result: 1.Compared with SO group and HC group, the ACR and β2-MG of NAFLD group were higher,and the eGFR were lower. The age,sex,BMI, waist circumference,TC,TG,HDL,LDL,FBG and 2-hour postprandial sugar levels of NAFLD group and SO group were no significant difference. However the ACR,β2-MG and eGFR of NAFLD group and SO group were significant difference.2. Spearman correlation showed ACR was positively correlated with waist circumference,FBG,FINS,2h postprandial plasma glucose,TG,TC,LDL,HOMA-IR and BMI, and negatively correctled with HDL. Further multiple regression analysis showed HOMA-IR were important predictors of early renal damage.3.The comparison of HC group and SO group showed that ACR,β2-MG were statistically different(P<0.05),and Scr,eGFR were not statistically different.Conclusion: 1.NAFLD is closely related to chronic kidney disease(CKD) at same baseline of sex, age, blood glucose, blood fat, blood pressure and obesity.NAFLD may be a risk factor for CKD.2.NAFLD and CKD share some of the same risk factors and same pathogenesis, NAFLD patients with renal injury may be the results of NAFLD and other factors. Furthermore,NAFLD patients with IR were more likely to develop early kidney damage and CKD than patients with simple NAFLD.3.ACR combined with β2-MG were more sensitive than Scr and eGFR in detecting early renal damage.