Investigation of Changes in Liver Fibrosis Scores and Kidney Function in Patients with Diabetic Hepatosteatosis

Authors

Oytun Canbolat, Semahat Karahisar Şirali, Mehmet Fatih Bulucu
https://doi.org/10.18621/eurj.1795033
Objectives: Hepatosteatosis, diabetes, and chronic kidney disease are significant risk factors for mortality and morbidity. The objective of this study was to examine the relationship between non-invasive liver fibrosis scores and kidney function tests in patients with diabetic hepatosteatosis.
Methods: This present study was conducted through a retrospective analysis of two consecutive data sets of 72 diabetic patients aged 18–80 years of both sexes who were investigated for at our hospital between 2018 and 2024. The relationships between hepatosteatosis, diabetes mellitus parameters, kidney function tests, liver function tests, and fibrosis scores (BARD, BAAT, NFS, FIB4, APRI) were examined.
Results: Among the patients included in the study, 54.2% (n=39) were female, and the mean age was 60.99±12.46 years. A moderate negative correlation was found between the initial GFR and both initial FIB4 (P<0.001) and NFS values (P=0.001), while a weak negative correlation was observed between the final GFR and both final FIB4 (P=0.016) and NFS values (P=0.001). A weak negative association was observed between the differences in the initial and final GFR values and both the differences in BARD scores and BARD ratios (P=0.039). Linear regression analysis revealed that a one-unit increase in the BARD ratio led to a 4.34-unit decrease in GFR.
Conclusions: The study revealed a correlation between fibrosis progression, as measured by repeated measurements, and an increased risk of developing new-onset chronic kidney disease. The findings of this study indicated that liver fibrosis in patients with diabetic hepatosteatosis might contribute to the development of chronic kidney disease, thereby underscoring the necessity for enhanced monitoring of kidney function.
Hepatosteatosis, Diabetes Mellitus, Liver Fibrosis Scores, Kidney Function

1. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology. 2012;55(6):2005-2023. doi: 10.1002/hep.25762.

2. Younossi Z, Anstee QM, Marietti M, et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol. 2018;15(1):11-20. doi: 10.1038/nrgastro.2017.109.

3. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77(4):1335-1347. doi: 10.1097/HEP.0000000000000004.

4. Estes C, Anstee QM, Arias-Loste MT, et al. Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030. J Hepatol. 2018;69(4):896-904. doi: 10.1016/j.jhep.2018.05.036.

5. Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, Loomba R. Fibrosis progression in nonalcoholic fatty liver vs nonalcoholic steatohepatitis: a systematic review and meta-analysis of paired-biopsy studies. Clin Gastroenterol Hepatol. 2015;13(4):643-654.e1-9; quiz e39-40. doi: 10.1016/j.cgh.2014.04.014.

6. GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-1544. doi: 10.1016/S0140-6736(16)31012-1.

7. Ginès P, Graupera I, Lammert F, et al. Screening for liver fibrosis in the general population: a call for action. Lancet Gastroenterol Hepatol. 2016;1(3):256-260. doi: 10.1016/S2468-1253(16)30081-4.

8. Blonde L, Umpierrez GE, Reddy SS, et al. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract. 2022;28(10):923-1049. doi: 10.1016/j.eprac.2022.08.002.

9. Xiong S, Wang P, Yin S, et al. The association between liver fibrosis scores and chronic kidney disease. Front Med (Lausanne). 2023;10:1046825. doi: 10.3389/fmed.2023.1046825.

10. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296-1305. doi: 10.1056/NEJMoa041031.

11. Weiner DE, Tighiouart H, Amin MG, et al. Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality: a pooled analysis of community-based studies. J Am Soc Nephrol. 2004;15(5):1307-1315. doi: 10.1097/01.asn.0000123691.46138.e2.

12. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004;291(7):844-850. doi: 10.1001/jama.291.7.844.

13. Chen J, Muntner P, Hamm LL, et al. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004;140(3):167-174. doi: 10.7326/0003-4819-140-3-200402030-00007.

14. Sesti G, Fiorentino TV, Arturi F, Perticone M, Sciacqua A, Perticone F. Association between noninvasive fibrosis markers and chronic kidney disease among adults with nonalcoholic fatty liver disease. PLoS One. 2014;9(2):e88569. doi: 10.1371/journal.pone.0088569.

15. Kotoku K, Michishita R, Matsuda T, et al. The Association between Decreased Kidney Function and FIB-4 Index Value, as Indirect Liver Fibrosis Indicator, in Middle-Aged and Older Subjects. Int J Environ Res Public Health. 2021;18(13):6980. doi: 10.3390/ijerph18136980.

16. Kuma A, Mafune K, Uchino B, Ochiai Y, Miyamoto T, Kato A. Potential link between high FIB-4 score and chronic kidney disease in metabolically healthy men. Sci Rep. 2022;12(1):16638. doi: 10.1038/s41598-022-21039-0.

17. Hydes TJ, Kennedy OJ, Buchanan R, et al. The impact of non-alcoholic fatty liver disease and liver fibrosis on adverse clinical outcomes and mortality in patients with chronic kidney disease: a prospective cohort study using the UK Biobank. BMC Med. 2023;21(1):185. doi: 10.1186/s12916-023-02891-x.

18. Schleicher EM, Gairing SJ, Galle PR, et al. A higher FIB-4 index is associated with an increased incidence of renal failure in the general population. Hepatol Commun. 2022;6(12):3505-3514. doi: 10.1002/hep4.2104.

19. Seko Y, Yano K, Takahashi A, et al. FIB-4 Index and Diabetes Mellitus Are Associated with Chronic Kidney Disease in Japanese Patients with Non-Alcoholic Fatty Liver Disease. Int J Mol Sci. 2019;21(1):171. doi: 10.3390/ijms21010171.

20. Wijarnpreecha K, Thongprayoon C, Scribani M, Ungprasert P, Cheungpasitporn W. Noninvasive fibrosis markers and chronic kidney disease among adults with nonalcoholic fatty liver in USA. Eur J Gastroenterol Hepatol. 2018;30(4):404-410. doi: 10.1097/MEG.0000000000001045.

21. Supriyadi R, Yanto TA, Hariyanto TI, Suastika K. Utility of non-invasive liver fibrosis markers to predict the incidence of chronic kidney disease (CKD): A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2023;17(8):102814. doi: 10.1016/j.dsx.2023.102814.

22. Mima A. Prediction of decreased estimated glomerular filtration rate using liver fibrosis markers: a renal biopsy-based study. Sci Rep. 2022;12(1):17630. doi: 10.1038/s41598-022-22636-9.

There are 22 references in total.
1.
Canbolat O, Karahisar Şirali S, Bulucu MF. Investigation of Changes in Liver Fibrosis Scores and Kidney Function in Patients with Diabetic Hepatosteatosis. Eur Res J. 2026;12(5):1-8. doi:10.18621/eurj.1795033

Downloads

Article Information

  • File Downloads 5
  • Abstract Views 13
  • Altmetrics
  • Share
Download data is not yet available.