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Cai, X. ; Thorand, B. ; Hohenester, S.* ; Koenig, W.* ; Rathmann, W.* ; Peters, A. ; Nano, J.

Association between the fatty liver index and chronic kidney disease: The population-based KORA study.

Nephrol. Dial. Transplant. 38, 1240-1248 (2022)
Publ. Version/Full Text Postprint DOI PMC
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BACKGROUND: We aimed to evaluate the relationship of fatty liver, estimated by fatty liver index (FLI), with kidney function and chronic kidney disease (CKD) in a German cohort study, given the lack of prospective evidence in Europeans. METHODS: We included 2920 participants (51.6% women, mean age 56.1 years) from the KORA study, of which 1991 were followed up for an average of 6.4 (± 0.3) years. Kidney function was assessed using the glomerular filtration rate estimated by creatinine (eGFR-cr) or cystatin C (eGFR-cc). We used multiple logistic or linear regressions to evaluate the associations between FLI, kidney function and CKD (eGFR < 60 ml/min per 1.73 m2), and mediation analysis to explore the mediation effects of metabolic factors. RESULTS: The prevalence of FLI ≥ 60 and CKD were 40.4% and 5.6% at baseline, and 182 participants developed CKD during the follow-up. Cross-sectionally, FLI was significantly inversely associated with eGFR-cc [β, 95%CI: -1.14 (-1.81, -0.47)] and prevalent CKD based on eGFR-cc [OR, 95%CI: 1.28 (1.01, 1.61)], but not with other markers. After adjusting for lifestyle factors, we found a positive association between FLI and incident CKD defined by eGFR-cc or/eGFR-cr, which was attenuated after controlling for metabolic risk factors. Mediation analysis showed that the association was completely mediated by inflammation, diabetes and hypertension jointly. CONCLUSIONS: The positive association between FLI and CKD incidence was fully mediated by the joint effect of metabolic risk factors. Future longitudinal studies need to explore the chronological interplay between fatty liver, cardiometabolic risk factors and kidney function with repeated measurements.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Cardiometabolic Risk Factors ; Chronic Kidney Disease ; European Cohort ; Fatty Liver Index ; Mediation Analysis
ISSN (print) / ISBN 0931-0509
e-ISSN 1460-2385
Journal Nephrology Dialysis Transplantation
Quellenangaben Volume: 38, Issue: 5, Pages: 1240-1248 Article Number: , Supplement: ,
Publisher Oxford University Press
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology II (EPI2)
Grants State of Bavaria
Bundesministerium fur Bildung und Forschung (the German FederalMinistry of Education and Research)
Deutsches Forschungszentrum fur Gesundheit und Umwelt, Helmholtz Zentrum Munchen (German Research Center for Environmental Health)