Abstract：
OBJECTIVE: The new nomenclature of steatotic liver disease (SLD) including metabolic dysfunction-associated SLD (MASLD), MASLD and increased alcohol intake (MetALD), and alcohol-associated liver disease (ALD) has recently been proposed. We aimed to elucidate the relationship between each category of SLD and chronic kidney disease (CKD).
METHODS: We investigated the effects of various SLDs on the development of CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or positive for urinary protein, during a 10-year period in 12 138 Japanese subjects (men / women, 7984/4154; mean age, 48 years) who received annual health examinations including abdominal ultrasonography.
RESULTS: The prevalences of SLD without metabolic dysfunction (SLD-MD[-]), MASLD, MetALD, and ALD were 1.7%, 26.3%, 4.9%, and 1.9%, respectively. During the follow-up period, 1963 subjects (16.2%) (men / women, 1374 [17.2%]/589 [14.2%]) had new onset of CKD. Multivariable Cox proportional hazard model analyses after adjustment of age, sex, eGFR, current smoking habit, diabetes mellitus, hypertension, and dyslipidemia showed that the hazard ratios (HR [95% confidence interval]) for the development of CKD in subjects with MASLD (1.20 [1.08-1.33], p = 0.001) and those with ALD (1.41 [1.05-1.88], p = 0.022), but not those with MetALD (1.11 [0.90-1.36], p = 0.332), were significantly higher than the HR in subjects with non-SLD. Interestingly, subjects with SLD-MD[-] had a significantly lower HR (0.61 [0.39-0.96], p = 0.034) than that in subjects with non-SLD. The addition of the novel classification of SLDs into traditional risk factors for the development of CKD significantly improved the discriminatory capacity.
CONCLUSIONS: MASLD and ALD, but not SLD-MD[-], are independently associated with the development of CKD.
METHODS: We investigated the effects of various SLDs on the development of CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or positive for urinary protein, during a 10-year period in 12 138 Japanese subjects (men / women, 7984/4154; mean age, 48 years) who received annual health examinations including abdominal ultrasonography.
RESULTS: The prevalences of SLD without metabolic dysfunction (SLD-MD[-]), MASLD, MetALD, and ALD were 1.7%, 26.3%, 4.9%, and 1.9%, respectively. During the follow-up period, 1963 subjects (16.2%) (men / women, 1374 [17.2%]/589 [14.2%]) had new onset of CKD. Multivariable Cox proportional hazard model analyses after adjustment of age, sex, eGFR, current smoking habit, diabetes mellitus, hypertension, and dyslipidemia showed that the hazard ratios (HR [95% confidence interval]) for the development of CKD in subjects with MASLD (1.20 [1.08-1.33], p = 0.001) and those with ALD (1.41 [1.05-1.88], p = 0.022), but not those with MetALD (1.11 [0.90-1.36], p = 0.332), were significantly higher than the HR in subjects with non-SLD. Interestingly, subjects with SLD-MD[-] had a significantly lower HR (0.61 [0.39-0.96], p = 0.034) than that in subjects with non-SLD. The addition of the novel classification of SLDs into traditional risk factors for the development of CKD significantly improved the discriminatory capacity.
CONCLUSIONS: MASLD and ALD, but not SLD-MD[-], are independently associated with the development of CKD.
摘要：
目的：新命名的脂肪变性肝病（SLD），包括代谢功能障碍相关的SLD（MASLD），MASLD和增加酒精摄入量（MetALD），和酒精相关性肝病（ALD）最近被提出。我们旨在阐明SLD的每个类别与慢性肾脏疾病（CKD）之间的关系。
方法：我们研究了各种SLD对CKD发展的影响，定义为估计的肾小球滤过率（eGFR）<60mL/min/1.73m2或尿蛋白阳性，在12.138名日本科目的10年期间(男性/女性，7984/4154；平均年龄，48岁)接受年度健康检查，包括腹部超声检查。
结果：无代谢功能障碍的SLD（SLD-MD[-]），MASLD,MetALD,ALD是1.7%，26.3%,4.9%,和1.9%，分别。在后续期间,1963年受试者（16.2%）（男性/女性，1374[17.2%]/589[14.2%])新发CKD。调整年龄后的多变量Cox比例风险模型分析，性别,eGFR,目前的吸烟习惯，糖尿病,高血压,和血脂异常显示MASLD受试者中CKD发展的风险比（HR[95%置信区间]）（1.20[1.08-1.33]，p=0.001)和ALD(1.41[1.05-1.88]，p=0.022),但不是那些有MetALD(1.11[0.90-1.36]，p=0.332)，显著高于非SLD受试者的HR。有趣的是,患有SLD-MD[-]的受试者的HR显着降低（0.61[0.39-0.96]，p=0.034）高于非SLD受试者。将SLD的新分类添加到CKD发展的传统危险因素中，显着提高了辨别能力。
结论：MASLD和ALD，但不是SLD-MD[-]，与CKD的发展独立相关。
方法：我们研究了各种SLD对CKD发展的影响，定义为估计的肾小球滤过率（eGFR）<60mL/min/1.73m2或尿蛋白阳性，在12.138名日本科目的10年期间(男性/女性，7984/4154；平均年龄，48岁)接受年度健康检查，包括腹部超声检查。
结果：无代谢功能障碍的SLD（SLD-MD[-]），MASLD,MetALD,ALD是1.7%，26.3%,4.9%,和1.9%，分别。在后续期间,1963年受试者（16.2%）（男性/女性，1374[17.2%]/589[14.2%])新发CKD。调整年龄后的多变量Cox比例风险模型分析，性别,eGFR,目前的吸烟习惯，糖尿病,高血压,和血脂异常显示MASLD受试者中CKD发展的风险比（HR[95%置信区间]）（1.20[1.08-1.33]，p=0.001)和ALD(1.41[1.05-1.88]，p=0.022),但不是那些有MetALD(1.11[0.90-1.36]，p=0.332)，显著高于非SLD受试者的HR。有趣的是,患有SLD-MD[-]的受试者的HR显着降低（0.61[0.39-0.96]，p=0.034）高于非SLD受试者。将SLD的新分类添加到CKD发展的传统危险因素中，显着提高了辨别能力。
结论：MASLD和ALD，但不是SLD-MD[-]，与CKD的发展独立相关。
