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Abstract: FR-PO821

Association Between the Fibrosis-4 (FIB-4) Score and ≥20% Decline in the Estimated Glomerular Filtration Rate in the General Population with Abdominal Adiposity

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism

Authors

  • Kuma, Akihiro, Hyogo Medical University, Nishinomiya, Japan
  • Nanami, Masayoshi, Hyogo Medical University, Nishinomiya, Japan
  • Kuragano, Takahiro, Hyogo Medical University, Nishinomiya, Japan
  • Kato, Akihiko, Hamamatsu University Hospital, Hamamatsu, Japan
Background

The prevalence of chronic kidney disease is increasing in patients with non-alcoholic fatty liver disease (NAFLD), and obesity is a known risk factor for both conditions. The fibrosis index based on four factors (FIB-4) score, a non-invasive indicator, is strongly associated with liver injury and fibrosis in patients with NAFLD. The association between the FIB-4 score and the estimated glomerular filtration rate (eGFR) slope remains unclear. In this study, we investigated whether the FIB-4 score is associated with eGFR decline in the general population.

Methods

This retrospective observational cohort study included individuals who underwent health check-ups across Japanese companies between 2009 and 2014. Participants who consumed ≥30 g of alcohol/day were excluded. An FIB-4 score of ≥1.30, which indicates moderate-to-severe liver fibrosis, was set as the cut-off value. Propensity score matching based on FIB-4 scores (<1.30, ≥1.30) was performed to eliminate biases associated with covariances across participants’ backgrounds.

Results

We recruited 11,296 participants at baseline; however, 5943 participants were excluded, and data of 464 participants were analyzed after propensity score matching. Participants’ mean age was 50 years, mean eGFR was 74.7 mL/min/1.73 m2, and the mean waist circumference (WC) was 81.8 cm. FIB-4 scores ≥1.30 were significantly associated with ≥20% decline in the eGFR over 5-year follow-up (odds ratio [OR] 3.94, 95% confidence interval [CI] 1.29–12.06). Subgroup analysis showed that an FIB-4 score ≥1.30 was significantly associated with ≥20% decline in eGFR 5 years later in participants with WC ≥85 cm (OR 8.78, 95% CI 1.05–73.53) but not in those with WC <85 cm (OR 2.70, 95% CI 0.70–10.38).

Conclusion

Our findings show that an FIB-4 score ≥1.30 was associated with ≥20% decline in the eGFR 5 years later. Abdominal adiposity accompanied by an FIB-4 score ≥1.30 was a particularly important risk factor for eGFR decline.