AUTHOR=Su Weitao , Chen Minhui , Xiao Ling , Du Shanshan , Xue Lihua , Feng Ruimei , Ye Weimin 

TITLE=Association of metabolic dysfunction-associated fatty liver disease, type 2 diabetes mellitus, and metabolic goal achievement with risk of chronic kidney disease

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1047794

DOI=10.3389/fpubh.2022.1047794

ISSN=2296-2565

ABSTRACT=Background: Although type 2 diabetes mellitus (T2DM) plays a significant role in association between metabolic dysfunction-associated fatty liver disease (MAFLD) and chronic kidney disease (CKD), how T2DM development and glycemic deterioration affects CKD and its renal function indicators, estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR), remains unknown. We aimed to assess association between MAFLD, along with T2DM, and risk of CKD, and then evaluate the effect of metabolic goal achievement in MAFLD on risk of CKD. 
Methods: In this cross-sectional study, 5594 participants were included. Multivariable logistic regression and linear regression were used to examine the association between MAFLD with its T2DM status and metabolic goal achievement and risk of CKD, as well as eGFR and UACR.
Results: MAFLD group had a higher prevalence of CKD (16.2% vs. 7.6%, P<0.001) than non-MAFLD group. MAFLD was independently associated with increased risk of CKD (OR: 1.35, 95% CI: 1.09-1.67) and increased eGFR and UACR. Among three MAFLD subtypes, only T2DM subtype exhibited significant associations with increased risk of CKD (OR: 2.85, 95% CI: 2.24-3.63), as well as increased eGFR and UACR. Glycemic deterioration in MAFLD was dose-dependently associated with increased risk of CKD (P-trend<0.001). Achieved metabolic goals in MAFLD decreased the risk of CKD, eGFR and UACR; MAFLD with 2 or 3 achieved metabolic goals was not significantly associated with risk of CKD (OR: 0.81, 95% CI: 0.59-1.12) and albuminuria.
Conclusions: MAFLD was independently associated with increased risk of CKD, as well as increased eGFR and UACR. This association is strongly driven by T2DM status. Glycemic deterioration in MAFLD was dose-dependently associated with increased risk of CKD. Achieved metabolic goals in MAFLD decreased the risk of CKD by reducing risk of albuminuria.