Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study
Authors' conclusion
High FLI scores are associated with a greater risk of ESRD in patients with type 2 diabetes with CKD at baseline. Close monitoring and appropriate management of hepatic steatosis may aid in preventing the progression of kidney dysfunction in patients with type 2 diabetes and CKD.
Study context
- Population
- Patients with T2D who underwent health screening 2009–2012, Korean National Health Insurance Services data; Fatty liver index (FLI) as surrogate marker of hepatic steatosis
- Participants
- 1,900,598 patients
- Exposure
- FLI 30-59 and FLI ≥ 60 vs FLI < 30
- Outcome
- Incident ESRD
- Follow-up
- Median 7.2 years
Methodological detailsnationwide, observational
- Nationwide
- Observational
Main finding
As reported in the abstract
Each group vs FLI < 30Hazard ratio (95% CI)
FLI 30-59
1.124(1.083–1.166)
FLI ≥ 60
1.278(1.217–1.343)
- Incident end-stage renal disease (ESRD) developed
- 19,476 of 1,900,598
Observational data: associations, not effects.
Further findings
Incident ESRD by sex, FLI ≥ 60
| HR (95% CI) | ||
|---|---|---|
| FLI ≥ 60 (male) | 1.106 (1.041–1.176) | |
| FLI ≥ 60 (female) | 1.835 (1.689–1.995) | |
| 0.512Hazard ratio (log scale) |
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident ESRD, FLI ≥ 60, in patients with CKD at baselineFLI ≥ 60vs FLI < 30 | 1.268 (1.198–1.342) | |
| 0.512Hazard ratio (log scale) |
- Incident ESRD, FLI ≥ 60, in patients with chronic kidney disease (CKD) at baseline: CKD: eGFR < 60 ml/min/1.73 m² (MDRD equation)
Incident ESRD by sex, FLI ≥ 60
- Association more prominent in women than in men
Incident ESRD, FLI ≥ 60, in patients with CKD at baseline
- Association between FLI ≥ 60 and ESRD risk differed according to baseline kidney function
Original publication
Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study. Diabetes Metab. Published 25 May 2023. doi:10.
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