Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 1;13(5):801-813.
doi: 10.21037/hbsn-23-558. Epub 2024 Jun 14.

Comparative associations of non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease with risk of incident chronic kidney disease: a cohort study

Ji Hye Heo  1 , Mi Yeon Lee  2 , Seong Hwan Kim  3 , Ming-Hua Zheng  4   5   6   7 , Christopher D Byrne  8   9 , Giovanni Targher  10 , Ki-Chul Sung  11
Affiliations

Comparative associations of non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease with risk of incident chronic kidney disease: a cohort study

Ji Hye Heo et al. Hepatobiliary Surg Nutr. .

Abstract

Background: We examined the comparative associations between non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) definitions with risk of developing chronic kidney disease (CKD) and abnormal albuminuria.

Methods: We conducted a cohort study of 214,145 Korean adults with normal kidney function at baseline who underwent liver ultrasonography. Participants were further subdivided into no steatotic liver disease (no-SLD), NAFLD-only, MASLD-only, both NAFLD and MASLD, and SLD not categorized as NAFLD or MASLD groups. Cox proportional hazards models were used to analyze the risk of incident CKD and albuminuria.

Results: Compared with either the no-NAFLD or no-MASLD groups, the NAFLD and MASLD groups were associated with a higher risk of incident CKD (NAFLD: adjusted hazard ratio (HR), 1.18 [95% CI, 1.01-1.38]; MASLD: adjusted HR, 1.21 [95% CI, 1.04-1.39]). Among the five subgroups, both NAFLD and MASLD group had the strongest association with risk of incident CKD (adjusted HR, 1.21 [95% CI, 1.04-1.42]). The MASLD-only group had the strongest association with incident abnormal albuminuria, with an adjusted HR comparable to that of the both NAFLD and MASLD group (adjusted HR 1.96 [95% CI, 1.44-2.67] for the MASLD-only, and adjusted HR 1.98 [95% CI, 1.58-2.49] for the both NAFLD and MASLD group versus the no-SLD group). The NAFLD-only group was not independently associated with risk of CKD or abnormal albuminuria.

Conclusions: These findings suggest that MASLD definition identifies individuals at high risk of developing incident CKD or abnormal albuminuria better than NAFLD definition.

Keywords: Metabolic dysregulation; albuminuria; chronic kidney disease (CKD); metabolic syndrome; non-alcoholic fatty liver disease (NAFLD).

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-23-558/coif). M.H.Z. serves as an unpaid editorial board member of Hepatobiliary Surgery and Nutrition. G.T. is supported in part by grants from the University School of Medicine of Verona, Verona, Italy. C.D.B. was supported in part by the Southampton National Institute for Health and Care Research Biomedical Research Centre (NIHR203319), UK. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Cumulative incidence rates of chronic kidney disease stage ≥3 by Kaplan-Meier methods according to presence and combination of NAFLD and/or MASLD. MASLD, metabolic dysfunction-associated steatotic liver disease; CKD, chronic kidney disease; NAFLD, non-alcoholic fatty liver disease; SLD, steatotic liver disease.
Figure 2
Figure 2
Cumulative incidence rates of abnormal albuminuria by Kaplan-Meier methods according to presence and combination of NAFLD and/or MASLD. MASLD, metabolic dysfunction-associated steatotic liver disease; NAFLD, non-alcoholic fatty liver disease; SLD, steatotic liver disease.
See this image and copyright information in PMC

Comment in

References

    1. Eslam M, El-Serag HB, Francque S, et al. Metabolic (dysfunction)-associated fatty liver disease in individuals of normal weight. Nat Rev Gastroenterol Hepatol 2022;19:638-51. 10.1038/s41575-022-00635-5 - DOI - PubMed
    1. Han E, Han KD, Lee YH, et al. Fatty Liver & Diabetes Statistics in Korea: Nationwide Data 2009 to 2017. Diabetes Metab J 2023;47:347-55. 10.4093/dmj.2022.0444 - DOI - PMC - PubMed
    1. Chan KE, Koh TJL, Tang ASP, et al. Global Prevalence and Clinical Characteristics of Metabolic-associated Fatty Liver Disease: A Meta-Analysis and Systematic Review of 10 739 607 Individuals. J Clin Endocrinol Metab 2022;107:2691-700. 10.1210/clinem/dgac321 - DOI - PubMed
    1. Mantovani A, Scorletti E, Mosca A, et al. Complications, morbidity and mortality of nonalcoholic fatty liver disease. Metabolism 2020;111S:154170. 10.1016/j.metabol.2020.154170 - DOI - PubMed
    1. Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023;79:1542-56. 10.1016/j.jhep.2023.06.003 - DOI - PubMed

LinkOut - more resources