INTRODUCTION The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) with renal insufficiency in recent years and the association between MAFLD and renal insufficiency is not entirely clear especially in overweight/obesity. The aim of this study was to analyze the prevalence and risk factors of MAFLD with renal insufficiency in overweight/obese adults. METHODS Individuals who attended check-up at the Second Affiliated Hospital of Xi'an Jiaotong University from 2016 to 2021 were included. The prevalence of MAFLD with renal insufficiency [estimate glomerular filtration rate (eGFR)≤90 ml/min/1.73 m2] in overweight/obesity was estimated. Propensity score-matched (PSM) analysis, univariate and multivariate analysis were used to determine the risk factors for MAFLD with renal insufficiency. RESULTS From 2016 to 2021, the prevalence of MAFLD in overweight/obesity reached its highest of 44.7% in 2017 and its lowest of 36.9% in 2018；and 33.9% in 2021 and 21.8% in 2019 is the highest and lowest prevalence of MAFLD with renal insufficiency, respectively. MAFLD was more common in men, old individuals, and persons with a higher BMI, and was characterized by significant renal insufficiency. MAFLD with renal insufficiency was more common in women, old individuals, and persons with a higher BMI, and was characterized by significant metabolic dysfunction and liver fibrosis. Multivariable analysis showed BMI, uric acid and fibrosis (evaluated with non-invasive liver fibrosis score FIB-4) were independent risk factors for MAFLD with renal insufficiency. CONCLUSION The prevalence of MAFLD with renal insufficiency in overweight/obese adults is quite high in the last 5 years. BMI, uric acid and fibrosis are independent risk factors for MAFLD with renal insufficiency.

中文翻译：

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超重/肥胖成人肾功能不全代谢功能障碍相关脂肪肝的患病率和危险因素。

简介 近年来，代谢功能障碍相关脂肪肝病 (MAFLD) 伴肾功能不全的患病率以及 MAFLD 与肾功能不全之间的关联尚不完全清楚，特别是在超重/肥胖中。本研究的目的是分析超重/肥胖成人肾功能不全的 MAFLD 患病率和危险因素。方法纳入2016年至2021年在西安交通大学第二附属医院体检的个体。估计超重/肥胖人群中肾功能不全的 MAFLD 患病率[估计肾小球滤过率 (eGFR)≤90 ml/min/1.73 m2]。采用倾向评分匹配（PSM）分析、单变量和多变量分析确定肾功能不全MAFLD的危险因素。结果 2016年至2021年，超重/肥胖人群MAFLD患病率最高，2017年为44.7%，最低为2018年36.9%；2021年为33.9%，2019年为21.8%，MAFLD患病率最高和最低分别为肾功能不全。MAFLD 在男性、老年人和体重指数较高的人群中更为常见，其特点是明显的肾功能不全。肾功能不全的MAFLD多见于女性、老年人和BMI较高的人群，其特点是明显的代谢功能障碍和肝纤维化。多变量分析显示BMI、尿酸和纤维化（以无创肝纤维化评分FIB-4评估）是MAFLD合并肾功能不全的独立危险因素。结论 近5年来超重/肥胖成人肾功能不全MAFLD患病率相当高。BMI、尿酸和纤维化是肾功能不全MAFLD的独立危险因素。