期刊
NUTRIENTS
卷 13, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/nu13103400
关键词
diabetes mellitus; ketone bodies; nonalcoholic fatty liver disease; fibrosis
资金
- 2020 Yeungnam University Research Grant
- Bio & Medical Technology Development Program of the National Research Foundation (NRF) - Korean government [2019M3E5D1A02068089]
- National Research Foundation of Korea [2019M3E5D1A02068089] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
The study investigated the association between spontaneous fasting ketonuria and liver fibrosis in NAFLD patients without prediabetes and diabetes mellitus. Results showed that patients with ketonuria were younger, had lower levels of glucose and insulin resistance, and had an inverse association with liver fibrosis compared to patients without ketonuria. The presence of ketonuria in these patients may have favorable metabolic effects.
Ketone body production, an alternative fuel upon low glucose availability, reduces hepatic fat accumulation. However, its clinical implications have not been established in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the association between spontaneous fasting ketonuria and liver fibrosis in patients with NAFLD without prediabetes and diabetes mellitus (DM). A total of 6202 patients with ultrasound confirmed NAFLD without prediabetes and DM were enrolled in the study. Using low cut off values of NAFLD fibrosis score (NFS) and fibrosis-4, liver fibrosis was defined as an intermediate-high probability of advanced liver fibrosis. Of the 6202 NAFLD patients, 360 (5.8%) had ketonuria. Compared to the patients without ketonuria, patients with ketonuria were younger (41.1 vs. 44.6 years, p < 0.001), had lower levels of glucose (87.2 vs. 91.0 mg/dL, p < 0.001), and homeostatic model assessment for insulin resistance (1.0 vs. 1.5, p < 0.001). The presence of ketonuria had an inverse association with liver fibrosis, assessed using both NFS (final adjusted odds ratio [aOR], 0.67; 95% confidence interval [CI], 0.45-1.01) and fibrosis-4 (aOR, 0.58; 95% CI, 0.40-0.84). The presence of ketonuria in NAFLD patients without prediabetes and DM may have favorable metabolic effects compared to the absence of ketonuria, independent of traditional metabolic factors.
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