Tissue inhibitor of metalloproteinase-1 and fibroscan as predictors for nonalcoholic fatty liver disease in chronic kidney disease patients attending Assiut University Hospitals
Background
Nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share mechanistic pathways related to metabolic dysfunction. The aim of this study was assessing prevalence of nonalcoholic liver disease among patients with CKD. in addition to, determine the relationship between the severity of fatty liver in nonalcoholic liver disease assessed by liver enzymes and tissue inhibitor of metalloproteinase-1 (TIMP-1).
Patients and methods
The current study enrolled a total of 80 patients with different stages of CKD. It was conducted in the period between March 2020 and March 2021. All patients were subjected to thorough medical history, clinical examination, baseline laboratory data, ultrasound, fibroscan, and also, the level of TIMP-1 was assessed.
Results
A total of 15 (18.8%) patients with CKD had NAFLD while the other 65 (81.2%) patients did not have NAFLD. Patients with NAFLD had significantly higher BMI and TIMP-1. There was a positive correlation between the grade of NAFLD as detected by fibroscan and the stage of CKD. Also, the NAFLD group had a significant difference as regard liver stiffness where the majority (84.6%) of patients without NAFLD had f0 and the majority (73.3%) of those with NAFLD had f1. Predictors for the development of NAFLD among patients with CKD were; TIMP-1, estimated glomerular filtration rate, and degree of fibrosis. TIMP-I at cutoff point greater than 21, has 97.2% accuracy for prediction of NAFLD in patients with CKD while f1 degree of fibroscan has 89.7% accuracy for prediction of NAFLD in patients with CKD.
Conclusion
Patients with CKD are vulnerable to develop NAFLD. Early detection of those patients may help in improving their outcomes. Also, TIMP-1 is considered as a novel biomarker for early diagnosis of NAFLD in patients with CKD. fibroscan is considered an available, cheap, and noninvasive method for assessment of NAFLD severity.
