Variations in Estimated Glomerular Filtration Rate Across Countries in Patients With Metabolic Dysfunction‐Associated Steatotic Liver Disease and Their Association With Liver Fibrosis: A Multicenter Study

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disease globally. Previous studies have shown that MASLD is an independent risk factor for chronic kidney disease (CKD), but the variations in estimated glomerular filtration rate (eGFR) levels across countries with different ethnic backgrounds have not been extensively reported. We enrolled 3308 participants with biopsy-proven MASLD from 34 centers in this multinational study and analyzed the associations between eGFR and histological severity of liver fibrosis in different countries. European participants had lower eGFR levels (92.2 ± 20.7 vs. 104.7 ± 17.3 mL/min/1.73 m<sup>2</sup>) and significant liver fibrosis (61.4 vs. 32.4%) than Asian individuals. In Asia, Chinese participants had the highest mean eGFR level at 105.8 mL/min/1.73 m<sup>2</sup>, while Malaysian participants had the lowest at 87.3 mL/min/1.73 m<sup>2</sup> (<i>p</i> < 0.001). In Europe, French participants had the highest mean eGFR level at 95.3 mL/min/1.73 m<sup>2</sup>, while Romanian individuals had the lowest at 81.1 mL/min/1.73 m<sup>2</sup> (<i>p</i> < 0.001). eGFR levels were inversely associated with liver fibrosis in Asian individuals (OR: 0.793, 95%CI: 0.685-0.917, <i>p</i> = 0.002), even after adjusting for traditional renal risk factors, but not in Europeans. Our findings provide the basis for further investigation of the burden of MASLD on CKD risk in different countries.

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Publication Details

Journal
MedComm
Published
2025-11-24
DOI
https://doi.org/10.1002/mco2.70503
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
0.00

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article

Variations in Estimated Glomerular Filtration Rate Across Countries in Patients With Metabolic Dysfunction‐Associated Steatotic Liver Disease and Their Association With Liver Fibrosis: A Multicenter Study

Michael Pavlides, Geraldine Ooi, Atsushi Nakajima, Yu‐Chen Fan et al.
MedComm
Liver Disease Diagnosis and Treatment
article

Variations in Estimated Glomerular Filtration Rate Across Countries in Patients With Metabolic Dysfunction‐Associated Steatotic Liver Disease and Their Association With Liver Fibrosis: A Multicenter Study

Michael Pavlides, Geraldine Ooi, Atsushi Nakajima, Yu‐Chen Fan, Su Lin, Junqi Niu, Hong Tang, Jin Chai, Yiling Li, Christian Labenz, Takeshi Okanoue, Toshihide Shima, Yongning Xin, Liang Xu, Hong Deng, Ming‐Hua Zheng, Monica Lupșor‐Platon, Ferenc E. Mózes, Peter Eddowes, Xiumei Xu, Adèle Delamarre, Dan‐Qin Sun, Fanpu Ji, Masato Yoneda, Junping Shi, Fangping He, Yuemin Nan, Jeremy Cobbold, Yongjian Zhou, Xiaoling Chi, Huiqing Liang, Wah‐Kheong Chan, Jing Zhang, Chunyan Ye, Sanjiv Mahadeva, Christopher D. Byrne, Qing Ye, Jing Wang, Jiahui Zhang, Jie Li, Jing Zhao, Lei Li, Jidong Jia, Jacob George, Bihui Zhong, Yongfen Zhu, Jinjun Chen, Zhonghua Lu, Dong Ji, Chenghai Liu, Xuebing Yan, Qinglei Zeng, Giovanni Targher, Victor de Lédinghen
article en

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most prevalent chronic liver disease globally. Previous studies have shown that MASLD is an independent risk factor for chronic kidney disease (CKD), but the variations in estimated glomerular filtration rate (eGFR) levels across countries with different ethnic backgrounds have not been extensively reported. We enrolled 3308 participants with biopsy-proven MASLD from 34 centers in this multinational study and analyzed the associations between eGFR and histological severity of liver fibrosis in different countries. European participants had lower eGFR levels (92.2 ± 20.7 vs. 104.7 ± 17.3 mL/min/1.73 m<sup>2</sup>) and significant liver fibrosis (61.4 vs. 32.4%) than Asian individuals. In Asia, Chinese participants had the highest mean eGFR level at 105.8 mL/min/1.73 m<sup>2</sup>, while Malaysian participants had the lowest at 87.3 mL/min/1.73 m<sup>2</sup> (<i>p</i> < 0.001). In Europe, French participants had the highest mean eGFR level at 95.3 mL/min/1.73 m<sup>2</sup>, while Romanian individuals had the lowest at 81.1 mL/min/1.73 m<sup>2</sup> (<i>p</i> < 0.001). eGFR levels were inversely associated with liver fibrosis in Asian individuals (OR: 0.793, 95%CI: 0.685-0.917, <i>p</i> = 0.002), even after adjusting for traditional renal risk factors, but not in Europeans. Our findings provide the basis for further investigation of the burden of MASLD on CKD risk in different countries.

MedCommVol. 6(12)
Qingdao University (CN), Hebei Medical University (CN), Jiangnan University (CN), Guangzhou University of Chinese Medicine (CN), University of Verona (IT), The University of Sydney (AU), Fujian Medical University (CN), Union Hospital (HK), Nottingham University Hospitals NHS Trust (GB), University of Nottingham (GB), Army Medical University (CN), Sun Yat-sen University (CN), Xuzhou Medical College (CN), Capital Medical University (CN), Jilin University (CN), Johannes Gutenberg University Mainz (DE), Anhui Medical University (CN), Nantong University (CN), Iuliu Hațieganu University of Medicine and Pharmacy (RO), Sichuan University (CN), Wenzhou Medical University (CN), Southampton General Hospital (GB), First Affiliated Hospital of Wenzhou Medical University (CN), Sir Run Run Shaw Hospital (CN), John Radcliffe Hospital (GB), Chinese PLA General Hospital (CN), Westmead Hospital (AU), Southwest Medical University (CN), University of Malaya (MY), National Institute for Health and Care Research (GB), University of Oxford (GB), Affiliated Hospital of Southwest Medical University (CN), Third Hospital of Hebei Medical University (CN), Tianjin Third Central Hospital (CN), West China Hospital of Sichuan University (CN), Institutul Regional de Gastroenterologie Prof. Dr. Octavian Fodor (RO), University Medical Center of the Johannes Gutenberg University Mainz (DE), The Seventh Affiliated Hospital of Sun Yat-sen University (CN), Shanghai University of Traditional Chinese Medicine (CN), Ospedale Sacro Cuore Don Calabria (IT), Nanfang Hospital (CN), Affiliated Hospital of Hangzhou Normal University (CN), NIHR Southampton Respiratory Biomedical Research Unit (GB), Nanjing Drum Tower Hospital (CN), Tianjin People's Hospital (CN), Wuxi Fourth People's Hospital (CN), Guangzhou First People's Hospital (CN), Affiliated Hospital of Qingdao University (CN), NIHR Southampton Biomedical Research Centre (GB), Qingdao Municipal Hospital (CN), Hôpital Cardiologique du Haut-Lévêque (FR), First Affiliated Hospital of Fujian Medical University (CN), First Hospital of Jilin University (CN), Wuxi No.2 People's Hospital (CN), Saiseikai Suita Hospital (JP), The First Affiliated Hospital, Sun Yat-sen University (CN), Southwest Hospital (CN), Second Affiliated Hospital of Xi'an Jiaotong University (CN), Wuxi Vocational Institute of Commerce (CN), First Affiliated Hospital of Anhui Medical University (CN), Westmead Institute (AU), First Hospital of China Medical University (CN), Westmead Institute for Medical Research (AU), Oxford BioMedica (United Kingdom) (GB), Nottingham Biomedical Research Centre (GB), Third Affiliated Hospital of Sun Yat-sen University (CN), Beijing YouAn Hospital (CN), Beijing Friendship Hospital (CN), Shuguang Hospital (CN), Changzhou Third People's Hospital (CN), First Affiliated Hospital of Zhengzhou University (CN), Wuxi People's Hospital (CN), Zhejiang Mariculture Research Institute (CN), Qilu Hospital of Shandong University (CN), Chengdu University of Traditional Chinese Medicine (CN), Monash University (AU), Tianjin Medical University (CN), Southern Medical University (CN), Yokohama City University (JP), South China University of Technology (CN), China Medical University (CN), Guangzhou Medical University (CN)
National Institute for Health and Care Research, National Natural Science Foundation of China, China Postdoctoral Science Foundation, Università degli Studi di Verona
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