{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T15:41:54Z","timestamp":1773416514949,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T00:00:00Z","timestamp":1689984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diabetic nephropathy (DN) is a major complication of diabetes. Nonalcoholic fatty liver disease (NAFLD) is common in diabetes, and liver fibrosis is a prognostic risk factor for NAFLD. The interaction between DN and liver fibrosis in NAFLD remains unclear. In 189 patients with DN and NAFLD who received an education course about diabetic nephropathy, liver fibrosis was evaluated using the fibrosis-4 (FIB-4) index. The association between the outcome of DN and changes in liver fibrosis was examined. The FIB-4 index was maintained at the baseline level in patients with improved DN, while it was increased in other patients. The \u0394FIB-4 index was positively correlated with changes in albuminuria and proteinuria (\u03c1 = 0.22, p = 0.004). In a multivariate analysis, changes in albuminuria and proteinuria were associated with the \u0394FIB-4 index (p = 0.002). Patients with a progressive FIB-4 index category from baseline to 5 years showed a lower event-free survival rate after 5 years than patients with an improved FIB-4 index category (p = 0.037). The outcome of DN is associated with changes in liver fibrosis in patients with diabetes, NAFLD and DN. Developing a preventive and therapeutic approach for these conditions is required.<\/jats:p>","DOI":"10.3390\/nu15143248","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T01:12:28Z","timestamp":1690161148000},"page":"3248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Change in Liver Fibrosis Associates with Progress of Diabetic Nephropathy in Patients with Nonalcoholic Fatty Liver Disease"],"prefix":"10.3390","volume":"15","author":[{"given":"Yoshiko","family":"Terasaka","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan"},{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-4389","authenticated-orcid":false,"given":"Hirokazu","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan"},{"name":"Liver Center, Saga University Hospital, Faculty of Medicine, Saga University, Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazushi","family":"Amano","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koshiro","family":"Fujisaki","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"},{"name":"Fujisaki Clinic, Kagoshima 891-0141, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shotaro","family":"Kita","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaori","family":"Kato","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"},{"name":"Ryutokukai Medical Corp, Tsuruta Hospital, Miyazaki 881-0016, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koujin","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuko","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuji","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Internal Medicine, Heiwadai Hospital, Miyazaki 880-0034, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keizo","family":"Anzai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga 849-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.2337\/dci22-0027","article-title":"Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"45","author":"Khunti","year":"2022","journal-title":"Diabetes Care"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Kidney Disease: Improving Global Outcomes Diabetes Work Group (2020). 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