Albuminuria Is Associated with Hepatic Iron Load in Patients with Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome
Abstract
:1. Introduction
2. Methods
2.1. Subjects
2.2. Ethics
2.3. General Data
2.4. Anthropometric Measurements
2.5. Adherence to the Mediterranean Diet
2.6. Blood and Urine Sample Collection
2.7. Blood and Urine Sample Analysis
2.8. Diagnosis of NAFLD
2.9. Statistical Analysis
3. Results
4. Discussion
5. Strengths and Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Clinical Trials Registration
References
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Female | 30 (40.0%) |
---|---|
Who were having menopause | 19 (25.3%) |
Age (y) (mean ± SD) | 52.7 ± 6.7 (6.86) |
Currently smoking | 6 (8.0%) |
Alcohol ≥7 drinks/week | 12 (16.0%) |
Regular physical activity | |
None | 34 (45.3%) |
Light | 27 (36.0%) |
Moderate | 12 (16.0%) |
Heavy | 2 (2.7%) |
Type 2 diabetes | 20 (26.7%) |
Hypertension | 43 (57.3%) |
Concomitant medications | |
Hypoglycemic agents | |
Oral hypoglycemic agents alone | 18 (24.0%) |
Antihypertensive agents | |
Any | 31 (41.3%) |
Diuretics | 12 (16.0%) |
μ-blockers | 5 (6.7%) |
Calcium-channel blockers | 4 (5.3%) |
ACE inhibitors, ARBs | 28 (37.3%) |
Lipid-lowering agents | |
Any | 23 (30.7%) |
Statins alone | 14 (18.7%) |
Fibrate alone | 6 (8.0%) |
Statins and fibrate | 3 (4.0%) |
Antiplatelet agents | 3 (4.0%) |
Concomitant medications—other | |
Any | 49 (65.3%) |
Thyroid medications | 6 (8%) |
Depression/anxiety/insomnia | 14 (18.7%) |
Gout medications | 9 (12.0%) |
Mean ± SD | Median (IQR) | |
---|---|---|
Anthropometric variables | ||
Weight (kg) | 94.1 ± 13.7 | 92.2 (18.6) |
BMI (kg/m2) | 33.6 ± 4.0 | 32.6 (6.0) |
Waist circumference (cm) | 112.9 ± 8.8 | 111.3 (14.6) |
Total body fat (kg) | 32.7 ± 8.0 | 30.3 (9.2) |
Total body fat (%) | 34.7 ± 6.7 | 33.4 (11.4) |
Clinical parameters | ||
Systolic BP (mmHg) | 137.3 ± 16.8 | 136.3 (20.2) |
Diastolic BP (mmHg) | 82.6 ± 9.3 | 80.7 (13.4) |
MAP (mmHg) | 100.9 ± 11.1 | 99.0 (13.6) |
HR (bpm) | 70.6 ± 10.8 | 70.2 (14.1) |
Metabolic variables | ||
Glycemia (mg/dL) | 114.1 ± 44.1 | 105.0 (23.0) |
HbA1c (%) | 6.0 ± 1.2 | 5.7 (0.6) |
Fasting insulin (µIU/L) | 19.5 ± 9.5 | 17.8 (12.7) |
HOMA-IR | 5.6 ± 3.4 | 5.1 (4.5) |
Blood lipids | ||
Total cholesterol (mg/dL) | 210.0 ± 41.5 | 210.0 (58.0) |
HDL cholesterol (mg/dL) | 42.4 ± 8.7 | 41.0 (9.0) |
LDL cholesterol (mg/dL) | 128.1 ± 32.5 | 127.0 (44.7) |
VLDL cholesterol (mg/dL) | 41.0 ± 30.7 | 35.0 (17.0) |
Triglycerides (mg/dL) | 203.4 ± 152.1 | 175.0 (86.0) |
Physical Activity | ||
METs (min/week) | 3072.2 ± 3641.2 | 1920.0 (2680.2) |
Mediterranean Diet Adherence | 8.1 ± 2.7 | 8.0 (4.0) |
Other variables | ||
Uric acid (mg/dL) | 6.3 ± 1.5 | 6.3 (1.8) |
Serum Ferritin (ng/mL) | 155.5 ± 156.6 | 98.0 (138.0) |
Transferrin (mg/dL) | 271.5 ± 38.0 | 268.5 (42.7) |
CK (U/L) | 149.9 ± 161.4 | 120.0 (91.0) |
PCR (mg/dL) | 0.5 ± 0.6 | 0.3 (0.5) |
TSH (mUI/L) | 2.02± 1.1 | 1.8 (1.3) |
Mean ± SD | Median (IQR) | |
---|---|---|
Hepatic variables | ||
Stages of NAFLD | ||
1: Mild (6.4%–17.4%) | 49 (65.3%) | |
2: Moderate (17.4%–22.1%) | 9 (12.0%) | |
3: Severe (>22.1%) | 17 (22.7%) | |
NAFLD—Mean liver fat % | 15.9 ± 9.9 | 12.4 (11.3) |
Stages of HepFe (ms) | ||
0: Normal (>20 ms) | 68 (90.7%) | |
1: Mild/moderate (10–20 ms) | 5 (6.7%) | |
2: Severe (<10 ms) | 2 (2.7%) | |
Hepatic iron load (mg/g) | 1.2 ± 0.3 | 1.1 (0.3) |
Hepatic iron load (ms) | 27.0 ± 5.5 | 26.9 (7.1) |
Stages of fibrosis | ||
F0–F1: Normal (<6.44 kPa) | 55 (73.3%) | |
F2: Mild (6.44–7.81 kPa) | 7 (9.3%) | |
F3: Moderate (7.82–8.39 kPa) | 1 (1.3%) | |
F4: Severe (>8.39 kPa) | 4 (5.3%) | |
Fibrosis (kPa) | 5.2 ± 1.5 | 4.90 (1.80) |
Liver function test | ||
AST (IU/L) | 27.1 ± 14.6 | 23.0 (11.50) |
ALT (IU/L) | 38.4 ± 34.7 | 31.0 (25.0) |
GGT (IU/L) | 58.4 ± 71.5 | 38.0 (28.0) |
Total bilirubin (mg/dL) | 0.71± 0.4 | 0.60 (0.35) |
Platelets (103/uL) | 238.4 ± 46.8 | 240.0 (63.0) |
Kidney function | ||
MDRD (ml/min/1.73 m2) | 91.7 ± 14.2 | 94.4 (18.9) |
CKD-EPI (ml/min/1.73 m2) | 92.3 ± 17.9 | 98.8 (16.7) |
Serum albumin (g/L) | 4.4 ± 0.4 | 4.4 (0.3) |
Serum creatinine (mg/dL) | 0.8 ± 0.2 | 0.8 (0.1) |
Urea (mg/dL) | 37.3 ± 10.6 | 34.0 (15.0) |
Urine albumin (mg/L) | 13.4 ± 21.4 | 6.0 (11.5) |
Urine creatinine (mg/L) | 121.7 ± 48.5 | 116.9 (64.8) |
UACR (mg/g) | 11.3 ± 17.5 | 5.6 (7.75) |
Albuminuria high normal (10–29 mg/g) | 20 (26.0%) | |
Increased albuminuria (>30 mg/g) | 6 (8.0%) |
b (95%CI) | Std. Error | β | p | |
---|---|---|---|---|
Model 1—Variables | ||||
(Constant) | −1.48 (−2.63–(−0.32)) | 0.58 | 0.010 | |
NAFLD—Mean liver fat % | 0.00 (−0.01–0.01) | 0.01 | −0.09 | 0.490 |
Triglycerides (mg/dL) | 0.00 (0.00–0.00) | 0.00 | 0.04 | 0.740 |
Hepatic iron load (mg/g) | 0.43 (0.02–0.84) | 0.20 | 0.30 | 0.040 |
Serum Ferritin (ng/mL) | 0.00 (0.00–0.00) | 0.00 | 0.33 | 0.020 |
Fasting insulin (µIU/L) # | 1.00 (−0.01–2.01) | 0.51 | 0.55 | 0.050 |
HOMA-IR # | −0.60 (−1.46–0.26) | 0.43 | −0.40 | 0.170 |
Platelets (103/uL) | 0.00 (0.00–0.01) | 0.00 | 0.48 | < 0.001 |
Model 2—Variables | ||||
(Constant) | −4.26 (−7.95–(−0.58)) | 1.84 | 0.020 | |
NAFLD—Mean liver fat % | 0.00 (−0.02–0.02) | 0.01 | 0.11 | 0.660 |
Triglycerides (mg/dL) | 0.00 (0.00–0.00) | 0.00 | 0.01 | 0.920 |
Hepatic iron load (mg/g) | 0.54 (0.08–1.00) | 0.23 | 0.38 | 0.020 |
Serum Ferritin (ng/mL) | 0.00 (0.00–0.00) | 0.00 | 0.34 | 0.040 |
Fasting insulin (µIU/L) # | 2.60 (0.01–5.18) | 1.29 | 1.43 | 0.049 |
HOMA-IR # | −2.10 (−4.53–0.33) | 1.21 | −1.41 | 0.090 |
Platelets (103/µL) | 0.00 (0.00–0.01) | 0.00 | 0.39 | 0.009 |
Gender (m/f) | 0.05 (−0.16–0.26) | 0.10 | 0.07 | 0.620 |
Age (y) | 0.01 (−0.01–0.03) | 0.01 | 0.17 | 0.230 |
eGFR (ml/min/1.73 m2) | 0.00 (0.00–0.01) | 0.00 | 0.20 | 0.150 |
HbA1c (%) | 0.16 (−0.05–0.37) | 0.11 | 0.51 | 0.140 |
T2DM (y/n) | −0.10 (−0.36–0.16) | 0.13 | −0.12 | 0.430 |
Stage of NAFLD (1/2/3) | −0.08 (−0.31–0.15) | 0.11 | −0.18 | 0.480 |
Liver fibrosis (y/n) | −0.01 (−0.25–0.23) | 0.12 | −0.01 | 0.920 |
Stage 0 (n = 68) | Stage 1–2 (n = 7) | ||
---|---|---|---|
Mean ± SD | Mean ± SD | p | |
Weight (kg) | 93.5 ± 13.5 | 101.0 ± 15.3 | 0.290 |
BMI (kg/m2) | 33.4 ± 4.0 | 34.7 ± 3.5 | 0.440 |
Waist circumference (cm) | 112.6 ± 8.7 | 115.8 ± 9.9 | 0.480 |
Systolic BP (mmHg) | 136.2 ± 16.6 | 149.7 ± 15.8 | 0.090 |
Diastolic BP (mmHg) | 81.7 ± 8.7 | 92.0 ± 10.4 | 0.060 |
MAP (mmHg) | 99.9 ± 10.6 | 111.2± 11.8 | 0.070 |
HR (bpm) | 70.1 ± 10.0 | 75.5 ± 17.5 | 0.490 |
Blood glucose (mg/dL) | 112.2 ± 44.2 | 132.3 ± 41.6 | 0.260 |
HbA1c (%) | 6.0 ± 1.3 | 6.1 ± 1.1 | 0.910 |
Fasting insulin (µIU/L)# | 19.0 ± 9.4 | 25.6 ± 9.2 | 0.130 |
HOMA-IR # | 5.3 ± 3.1 | 9.5 ± 5.4 | 0.040 |
Serum ferritin (ng/mL) | 125.1 ± 114.4 | 495.0 ± 172.1 | 0.003 |
HDL-cholesterol (mg/dL) | 42.6 ± 9.0 | 40.1 ± 3.3 | 0.160 |
Triglycerides (mg/dL) | 187.9 ± 97.7 | 353.1 ± 387.1 | 0.300 |
NAFLD (mean fat %) | 14.2 ± 7.5 | 31.8 ± 16.2 | 0.030 |
Fibrosis (kPa) | 5.1 ± 1.5 | 5.7 ± 1.0 | 0.200 |
HepFe (mg/g) | 1.1 ± 0.1 | 1.8 ± 0.5 | 0.007 |
Platelets (103/uL) | 240.5 ± 45.7 | 218.7 ± 56.8 | 0.360 |
MDRD (ml/min/1.73 m2) | 92.2 ± 13.7 | 86.2 ± 19.0 | 0.440 |
CKD-EPI (ml/min/1.73 m2) | 92.9 ± 16.9 | 86.5 ± 26.8 | 0.560 |
UACR (mg/g) # | 8.2 ± 8.5 | 40.0 ± 42.1 | 0.020 |
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Abbate, M.; Montemayor, S.; Mascaró, C.M.; Casares, M.; Gómez, C.; Ugarriza, L.; Tejada, S.; Abete, I.; Zulet, M.Á.; Sureda, A.; et al. Albuminuria Is Associated with Hepatic Iron Load in Patients with Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome. J. Clin. Med. 2021, 10, 3187. https://doi.org/10.3390/jcm10143187
Abbate M, Montemayor S, Mascaró CM, Casares M, Gómez C, Ugarriza L, Tejada S, Abete I, Zulet MÁ, Sureda A, et al. Albuminuria Is Associated with Hepatic Iron Load in Patients with Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome. Journal of Clinical Medicine. 2021; 10(14):3187. https://doi.org/10.3390/jcm10143187
Chicago/Turabian StyleAbbate, Manuela, Sofía Montemayor, Catalina M. Mascaró, Miguel Casares, Cristina Gómez, Lucía Ugarriza, Silvia Tejada, Itziar Abete, M. Ángeles Zulet, Antoni Sureda, and et al. 2021. "Albuminuria Is Associated with Hepatic Iron Load in Patients with Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome" Journal of Clinical Medicine 10, no. 14: 3187. https://doi.org/10.3390/jcm10143187