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Liver steatosis and the risk of albuminuria: the multi-ethnic study of atherosclerosis

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Journal of Nephrology Aims and scope Submit manuscript

Abstract

Objective

To measure association between hepatic fat and albuminuria (an early marker of renal injury) in individuals without diabetes or hypertension.

Methods

2,281 individuals in the Multi-Ethnic Study of Atherosclerosis without diabetes or hypertension, renal disease, or excess alcohol consumption underwent computed tomography (CT) for assessment of liver attenuation (marker of hepatic lipid content) and urinalysis (for albuminuria) at initial study visit, with assessment of incident and prevalent albuminuria by logistic regression in follow-up.

Results

After adjustment for age, gender, race, smoking, blood pressure, insulin resistance, and body mass index, individuals with less liver fat (higher liver CT attenuation) had a lower probability of having albuminuria at Exam 1 (OR per 10 unit increase in attenuation 0.77, 95 % CI 0.61–0.97, P = 0.02). At median 9.3 years follow-up, albuminuria was identified in 129 individuals were (5.8 %). In fully adjusted models (with age, smoking, body mass index, blood pressure, diabetes and hypertension as time-dependent covariates), lower liver attenuation (greater liver fat) was associated with higher risk of incident albuminuria (OR 0.79, 95 % CI 0.66–0.94, P = 0.008).

Conclusions

Hepatic attenuation is associated with prevalent and incident albuminuria, an early, potent risk factor for renal risk in a population not clearly at risk for future renal failure.

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Acknowledgments

The authors thank the other investigators, the staff, and the participants of the MESA study for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. MESA was supported by contracts N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute. All other authors have no financial disclosures relevant to the content of this manuscript. Dr. Shah is supported by a Fellow-to-Faculty Award from the American Heart Association. Dr. Allison was supported by funding for the MESA Abdominal Body Composition Ancillary study from the National Heart, Lung, and Blood Institute (R01-HL088451). MESA is supported by contracts N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute (NHLBI). Jingzhong Ding and Matthew J. Budoff are supported by R01-HL-085323 and R01-HL-071739, respectively, from NHLBI.

Conflict of interest

Dr. Murthy has minor stock in General Electric. There are no other disclosures for any other authors relevant to the content of this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Author notes

    Authors and Affiliations

    1. Department of Cardiology and Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Suite 454-East, Boston, MA, 02215, USA

      Ravi V. Shah

    2. Department of Family and Preventative Medicine, University of California-San Diego, San Diego, CA, USA

      Matthew A. Allison & Morgana Mongraw-Chaffin

    3. Cardiology Division, Johns Hopkins Medical Institute, Baltimore, MD, USA

      Joao A. C. Lima

    4. Department of Cardiology and Medicine, Brown University, Providence, RI, USA

      Siddique A. Abbasi

    5. Non-Invasive Cardiovascular Imaging, Brigham and Women’s Hospital, Boston, MA, USA

      Michael Jerosch-Herold

    6. Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA

      Jingzhong Ding

    7. Department of Cardiology and Medicine, University of California-Los Angeles, Los Angeles, CA, USA

      Matthew J. Budoff

    8. Cardiovascular Medicine Division, Department of Medicine, Nuclear Medicine and Cardiothoracic Imaging Divisions, Department of Radiology, University of Michigan, 1338 Cardiovascular Center, Ann Arbor, MI, USA

      Venkatesh L. Murthy

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    1. Ravi V. Shah
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    Correspondence to Ravi V. Shah or Venkatesh L. Murthy.

    Additional information

    R. V. Shah and V. L. Murthy contributed equally to this work, and are co-corresponding authors.

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    Shah, R.V., Allison, M.A., Lima, J.A.C. et al. Liver steatosis and the risk of albuminuria: the multi-ethnic study of atherosclerosis. J Nephrol 28, 577–584 (2015). https://doi.org/10.1007/s40620-015-0177-1

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    • DOI: https://doi.org/10.1007/s40620-015-0177-1

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