Evaluation of Renal Microvascular Damage by Measuring Microalbuminuria in Non-Alcoholic Fatty Liver Disease ??? A Study from Punjab, India

Author(s): Ankush Bansal1, Tejinder Sikri2, Satya Bhushan Nayyar3

Non-alcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome
characterized by obesity, dyslipidaemia, insulin resistance and diabetes mellitus
(DM). NAFLD represents another component of metabolic syndrome. NAFLD and
metabolic syndrome are associated with increased risk of atherosclerosis.
In the present comparative cross-sectional study, 100 cases with incidental NAFLD
and 100 healthy controls were subjected to detailed history, physical examination
including body-mass index (BMI) and biochemical investigations including renal
function tests (RFT), lipid profile and liver function tests (LFT). Microalbuminuria
was measured in these subjects to evaluate microvascular renal damage. Subjects
with alcoholic liver disease, chronic viral hepatitis, renal disease, etc were
The mean urine albumin creatinine ratio (UACR) in cases and controls was 35.81
± 27.81 and 7.88 ± 0.78 respectively. The mean UACR in grade 1 fatty liver was
16.31 ± 5.45, in grade 2 fatty liver was 28.64 ± 12.91, and 72.8 ± 27.10 in grade
3 fatty liver and they were compared with each other and were found to be
statistically significant with P value = 0.001.
The present study showed highly significant (P < 0.001) correlation between
microalbuminuria and NAFLD. There was a positive correlation which progresses
with increased grades of NAFLD. This correlation points towards a positive
relationship between increased renal microvascular damage and progression to
chronic kidney disease (CKD) in patients with NAFLD. The occurrence of NAFLD is
increasing mainly due to increasing obesity and metabolic syndrome. The clinical
implications of these findings for patient care are the detection of NAFLD by
routine ultrasonography (USG) especially in obese people and urine analysis for
microalbuminuria in these persons. This will help the clinician in determining
cardiovascular risks and risk of CKD in these apparently healthy persons.