Clinical Study On Evaluation Of Nonalcoholic Fatty Liver Disease And Related Factors In Patients With Chronic Kidney Disease Based On Transient Elastography

Objective(s):1.To investigate the correlation between non-alcoholic fatty liver disease(NAFLD)and controlled attenuation parameter(CAP)in non-diabetic chronic kidney disease(CKD)patients.To investigate whether CAP can be used for the evaluation of fatty liver in patients with non-dialysis CKD;2.To investigate the correlation between CAP and waist circumference,blood lipid and other clinical indicators in non-dialysis CKD patients,and to study the clinical related factors of NAFLD in non-dialysis CKD patients.Methods:1.141 patients with non-dialysis CKD were selected.According to the results of color Doppler ultrasonography,the combination of NAFLD was divided into CKD non-NAFLD group and CKD combined with NAFLD group.The differences between CAP,age,gender,smoking history,history of hypertension,history of diabetes,GFR,BMI,TC,and TG were compared between the two groups.Then the univariate analysis of the statistically significant factors as independent variables,combined with NAFLD as a dependent variable for unconditional two-class logistic regression analysis,respectively,to analyze the relevant influencing factors of NAFLD.Ultrasound was used to evaluate the ability of CAP to discriminate liver hepatic degeneration by ROC curve analysis.2.The 101 patients with non-dialysis CKD were selected as the study subjects.Pearson linear correlation analysis was used to evaluate the correlation between CAP and age,WC,GFR,TC and LogTG.Multiple linear regression was used to investigate the effects of WC,LogTG and gender on CAP.Results:1.141 patients with CKD,CKD did not have a combination of NAFLD in 109 patients,CKD combined with NAFLD in 32 patients.The results of analysis of variance showed that there was no significant difference in age,gender,smoking history,history of hypertension,history of diabetes,GFR,TC,etc.(P>0.05).Compared with the two groups,CAP was combined with NAFLD group.BMI and TG were higher,and the difference was statistically significant(P<0.01).Logistic regression analysis of NAFLD related factors,the results showed CAP(OR=1.016,95%CI 1.004-1.028,P<0.01),BMI(OR=1.224,95%CI1.028-1.457,P<0.05),TG(OR=1.743,95%CI 1.001-3.034,P=0.05).CAP,BMI,and TG may be risk factors for NAFLD.According to the ROC curve analysis,the optimal critical point of CAP for predicting hepatic steatosis was 261.5 dB/m.The sensitivity and specificity were 65.6%and 88.1%,respectively.The area under the curve was 0.784(95%CI:0.687-0.881,P<0.01).).2.The clinical data of 101 patients with CKD were analyzed by Pearson correlation analysis.Age,GFR,TC and CAP were not correlated.CAP was linear with WC(r=0.314,P<0.01)and LogTG(r=0.283,P<0.01).Positive correlation.Multiple linear regression analysis showed that variables such as gender,WC and IogTG were adjusted(corrected R2=0.171),and CAP was significantly positively correlated with WC(P<0.01),LogTG(P<0.01),and gender(P<0.05).Conclusion(s):1.In non-dialysis CKD patients,CAP,BMI,and TG may be risk factors for NAFLD.The transient elastography CAP value can be used as one of the non-invasive diagnostic NAFLD methods.2.In non-dialysis CKD patients,WC,TG and gender were positively associated with CAP.