Renal hyperfiltration, fatty liver index, and the hazards of all-cause and cardiovascular mortality in Finnish men

Abstract

OBJECTIVES Renal hyperfiltration (RHF) and fatty liver are separately associated with adverse health outcomes. In this study, we investigated the mortality hazard of coexisting RHF and fatty liver. METHODS Middle-aged men from the Kuopio Ischaemic Disease Risk Factor Study (n=1,552) were followed up for a median of 29 years. Associations among RHF, fatty liver index (FLI) score, age, body mass index, smoking status, alcohol consumption, and hypertension status were assessed using logistic regression. Cox proportional hazards models were used to determine the hazard ratios (HRs) for all-cause and cardiovascular disease (CVD) mortality with respect to RHF and fatty liver. RESULTS Of the men, 5% had RHF (n=73), whereas a majority had fatty liver (n=848). RHF was associated specifically with smoking, and fatty liver was associated specifically with overweight. The all-cause mortality hazard was highest (HR, 1.96; 95% confidence interval [CI], 1.27 to 3.01) among men with RHF and fatty liver (n=33). Among men with RHF but normal FLI (n=40), the HR of all-cause mortality was 1.67 (95% CI, 1.15 to 2.42). Among men with fatty liver but a normal estimated glomerular filtration rate (n=527), the HR of all-cause mortality was 1.35 (95% CI, 1.09 to 1.66). CVD mortality hazard was associated with RHF, but not fatty liver. We detected no interaction effect between RHF and fatty liver for all-cause (synergy index, 0.74; 95% CI, 0.21 to 2.67) or CVD (synergy index, 0.94; 95% CI, 0.34 to 2.60) mortality. CONCLUSIONS RHF and fatty liver are independently associated with all-cause and CVD mortality

Glomerular hyperfiltration: An independent risk factor and predictor of advanced coronary artery disease.

“…In 111 patients with essential hypertension and normal renal function, GHF was associated with a significant increase in left ventricular mass index, suggesting that elevated GFR may be an indicator for early target organ damage in these patients. 9 Similarly in our study GHF was also associated with hypertension (Diastolic > 100mm Hg) and a mean recorded blood pressure of 135/90 mm Hg. (P-<0.001).…”

The Fatty liver Index (FLI) 15 years later: a reappraisal

“…Lerchbaum et al [78] , by calculating FLI scores among 3270 subjects submitted to coronary angiography, found that, following a median follow-up time of 7.7 years, patients with high FLI scores compared to those with the lowest FLI scores were independently associated with increased mortality owing to all-causes, cardiovascular causes, and non-cardiovascular causes. The excess risk owing to fatal cancer was of borderline significance.…”

Sex-Specific Association of Body Mass Index And Fatty Liver Index With Prevalence of Renal Hyperfiltration: A Cross Sectional Study Using Japanese Health Check-Up Data

“…In addition, there have been several studies showing that FLI is not only a marker for NAFLD, but also a predictive marker for diabetes and CKD. However, the relationship between FLI and RHF has so far been reported in only one small cohort study in Finnish men [24]. In that study, no correlation was noted between the FLI and RHF; both were independently associated with all-cause and cardiovascular mortality.…”

“…Thus, low or high values of BMI are associated with an increased risk of mortality. Furthermore, several previous studies have argued that RHF is associated with mortality risk [7,24]. Therefore, the relationship between low body mass and RHF may re ect a completely different pathology than the relationship between obesity and RHF.…”