脂肪肝疾患の新しい定義により腎疾患の予測が向上
代謝異常と飲酒量に基づくSLD分類
札幌医科大学医学部の森和真氏らは、SLDの分類とCKD発症との関連を検討した。解析対象は、10年間にわたり腹部超音波検査を含む健診を受けていた日本人1万2,138人であった。
解析の結果、追跡期間中に対象者の16.2％（男性17.2％、女性14.2％）が新たにCKDを発症した。年齢、性別、推算糸球体濾過量（eGFR）、現在の喫煙習慣、糖尿病、高血圧、脂質異常症で調整後、CKD発症リスクは、MASLDおよびALDでは非SLDより高かったが、代謝機能障害アルコール関連肝疾患（MetALD）では関連が見られなかった。代謝機能障害を伴わないSLDでは、非SLDと比較して、CKD発症リスクが有意に低かった。従来のCKD発症リスク因子にSLDの新たな分類を加えることで、識別能が有意に向上した。
著者らは、「日常臨床にSLDの新しい分類を適用することで、SLD患者の中からCKDリスクの高い患者を特定することが可能である」と述べている。
New Definition of Steatotic Liver Disease Improves Prediction of Kidney Disease
Classification of SLD based on the presence of metabolic dysfunction and alcohol consumption
TUESDAY, Aug. 20, 2024 (HealthDay News) -- Using a new classification of steatotic liver disease (SLD) based on the presence of metabolic dysfunction and alcohol consumption, metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD) are significantly associated with the new onset of chronic kidney disease (CKD), according to a study published online Aug. 7 in Hepatology Research.
Kazuma Mori, M.D., from the Sapporo Medical University School of Medicine in Japan, and colleagues investigated the effects of various SLDs on the development of CKD. The analysis included 12,138 Japanese individuals with annual health examinations that included abdominal ultrasonography during a 10-year period.
The researchers found that during follow-up, 16.2 percent of participants (17.2 percent of men; 14.2 percent of women) had new onset of CKD. When adjusting for age, sex, estimated glomerular filtration rate, current smoking habit, diabetes mellitus, hypertension, and dyslipidemia, the risk for developing CKD was elevated in individuals with MASLD and those with ALD versus those with non-SLD; however, no association was seen for those with MASLD and increased alcohol intake. Compared with those with non-SLD, participants with SLD without metabolic dysfunction had a significantly lower risk for CKD. The addition of the novel classification of SLDs into traditional risk factors for the development of CKD significantly improved discriminatory capacity.
"In clinical practice, it is possible to identify patients at high risk for CKD among those with SLD by classifying hepatic steatosis according to the new classification of SLDs," the authors write.