Prevalence and risk factors of metabolic dysfunction-associated fatty liver disease with renal insufficiency in overweight/obese adults

Abstract

Introduction: The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) with renal insufficiency in recent years and the association between MAFLD and renal insufficiency is not entirely clear especially in overweight/obesity. The aim of this study was to analyze the prevalence and risk factors of MAFLD with renal insufficiency in overweight/obese adults. Methods: Individuals who attended check-up at the Second Affiliated Hospital of Xi'an Jiaotong University from 2016 to 2021 were included. The prevalence of MAFLD with renal insufficiency [estimate glomerular filtration rate (eGFR)≤90 ml/min/1.73 m2] in overweight/obesity was estimated. Propensity score-matched (PSM) analysis, univariate and multivariate analysis were used to determine the risk factors for MAFLD with renal insufficiency. Results: From 2016 to 2021, the prevalence of MAFLD in overweight/obesity reached its highest of 44.7% in 2017 and its lowest of 36.9% in 2018；and 33.9% in 2021 and 21.8% in 2019 is the highest and lowest prevalence of MAFLD with renal insufficiency, respectively. MAFLD was more common in men, old individuals, and persons with a higher BMI, and was characterized by significant renal insufficiency. MAFLD with renal insufficiency was more common in women, old individuals, and persons with a higher BMI, and was characterized by significant metabolic dysfunction and liver fibrosis. Multivariable analysis showed BMI, uric acid and fibrosis (evaluated with non-invasive liver fibrosis score FIB-4) were independent risk factors for MAFLD with renal insufficiency. Conclusion: The prevalence of MAFLD with renal insufficiency in overweight/obese adults is quite high in the last 5 years. BMI, uric acid and fibrosis are independent risk factors for MAFLD with renal insufficiency.