P0803SYNERGISTIC INTERACTION OF ACUTE HYPERGLYCEMIC STRESS AND NON-ALCOHOLIC FATTY LIVER DISEASE ON THE DEVELOPMENT OF ALBUMINURIA IN GENERAL POPULATION

Abstract Background and Aims Both increased glycemic exposure and non-alcoholic fatty liver disease (NFALD) are independent risks of vascular endothelial dysfunction. To find interactive effects of acute hyperglycemia and hepatic necro-inflammation on initiation of albuminuria, we conducted this nation-wide, population-based interaction analysis using acute-to-chronic glycemic ratio (ACGR) as a candidate indicator of acute increased glycemic exposure and ZJU index as an indicator of NFALD. Method Eligible as cases were all native Koreans aged 20 years or older without significant medical illness. A total of 9494 participants were divided into quintiles according to their ACGR results and stratified by sex. Results: Participants in the highest ACGR quintile were more obese and they were more likely to have elevated BP and increased glycemic exposure as compared with other quintiles. Restricted cubic regression analyses revealed that there was non-linear relationship of ACGR and ZJU index with albuminuria. Multiple logistic regression, adjusted for various conventional risk factor of kidney disease, demonstrated that both ACGR (adjusted OR = 5.388, 95% CI = 1.119-25.95) and ZJU index (adjusted OR = 1.057, 95% CI = 1.002-1.114) were independent predictor of albuminuria. Interestingly, our interaction analysis revealed that ACGR had bigger effect on the risk of albuminuria in participant with elevated ZJU index than those without (adjusted RERI = 2.296, 95% CI = 2.277-2.313; adjusted AP = 0.643, 95% CI = 0.472-0.814; adjusted SI = 8.135, 95% CI = 7.267-9.003). Conclusion Our findings suggest that the interaction of acute hyperglycemia and abnormal hepatic fat metabolism may exert synergistic biologic effect on the development of albuminuria.