Metabolic dysfunction, rather than obesity, is a risk factor for chronic kidney disease in Chinese population

Yang, Shan; Ling, Jiaxiu; Zhang, Siliang; Li, Yang; Yang, Gangyi

doi:10.1080/13685538.2024.2335158

Cited by 4 publications

(1 citation statement)

References 53 publications

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“…Diseases such as diabetes mellitus (DM), hypertension, and metabolic syndrome (MetS) are closely related to IR and are risk factors for CKD [ 5 ]. Based on body mass index (BMI) and MetS, CKD patients were classified into metabolically healthy normal weight/overweight/obesity and metabolically unhealthy normal weight/overweight/obesity groups according to a recent study, which demonstrated that metabolic abnormality was a significant risk factor for CKD in the Chinese population [ 6 ]. Due to its promotion of endothelial dysfunction, oxidative stress, and inflammation, IR may have a role in the onset and course of CKD [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016

Shen,

Lin,

Bin

et al. 2024

Diabetol Metab Syndr

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Background There is ongoing debate on the correlation between chronic kidney disease (CKD) and insulin resistance (IR)-related indices. Our objective was to explore the prognostic ability of IR-related indexes for the prevalence of CKD, as well as the mortality from all causes and cardiovascular disease (CVD) in CKD patients. Methods The data used in this study came from the National Health and Nutrition Examination Survey (NHANES). Binary logistic regression analysis, Cox proportional hazards model, and restricted cubic spline (RCS) were used to analyze the relationship between IR-related indexes, including metabolic score of IR (METS-IR), homeostatic model assessment for IR (HOMA-IR), triglyceride glucose index (TyG), triglyceride glucose-waist-to-height ratio (TyG-WHtR), triglyceride glucose-body mass index (TyG-BMI), with CKD and its all-cause mortality and CVD mortality. Subgroup analysis was performed to test the stability of the results. Finally, the predictive power of IR-related indexes for CKD was tested by the receiver operating characteristic (ROC) curve. Results Among the recruited 10,660 participants, 15.42% were CKD patients. All IR-related indexes were found to be nonlinearly correlated to the prevalence of CKD in the study. When the TyG index was higher than 9.05, it was positively associated with CKD (OR: 1.77, 95% CI 1.44–2.18). Moreover, increased TyG-WHtR level was correlated with a greater prevalence of CKD when it was higher than 4.3 (OR: 1.31, 95% CI 1.19–1.45). Other IR-related indexes (METS-IR, HOMA-IR, and TyG-BMI) showed fewer notable correlations with CKD. The association of IR-related indexes and the prevalence of CKD remained consistent in most subgroups (P for interactions > 0.05). TyG-WHtR was also the predictor of all-cause mortality in CKD patients (HR: 1.34, 95% CI 1.14–1.58), while other IR-related indexes were not correlated with the all-cause mortality or CVD mortality in CKD patients (P > 0.05). Otherwise, ROC curves showed that TyG-WHtR had more robust diagnostic efficacy than other IR-related indexes (METS-IR, HOMA-IR, TyG, and TyG-BMI) in predicting CKD (area under the curve: 0.630, 95% CI 0.615–0.644). Conclusions IR-related biomarkers (METS-IR, HOMA-IR, TyG, and TyG-BMI) were positively correlated with the prevalence of CKD. Moreover, TyG-WHtR enhanced CKD and its all-cause mortality prediction. In patients with elevated levels of IR-related indexes, the early detection and intervention of IR may reduce the occurrence of CKD and the prognosis of CKD patients.

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Section: Introductionmentioning

confidence: 99%

The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016

Shen,

Lin,

Bin

et al. 2024

Diabetol Metab Syndr

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The heart rate non-dipping pattern was associated with target organ damage in patients with chronic kidney disease

Zhou,

Dong,

Liu

et al. 2024

Int Urol Nephrol

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Prevalence of Metabolic Syndrome in People Living with HIV and its multi-organ damage: A prospective cohort study

Tang,

Chen,

Pan

et al. 2024

Preprint

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Introduction: With the global scale-up of antiretroviral therapy (ART) and improved life expectancy, people living with HIV (PLWH) increasingly face non-infectious comorbidities, and metabolic syndrome (MetS) is one of the most prevalent. MetS is associated with unfavorable health outcomes, including cardiovascular disease, chronic kidney disease, and metabolic dysfunction-associated fatty liver disease. However, data on the prevalence and risk factors of MetS among treatment-naïve PLWH in China are limited. The aim was to investigate the prevalence and risk factors of MetS and to understand its association with multi-organ damage. Methods: Data on sociodemographic, physical, and clinical characteristics were collected from a completed multicenter, prospective cohort study in China. MetS was diagnosed according to criteria proposed by the China Diabetes Society. Univariate and multivariable logistic regression were applied to identify associated risk factors for MetS. The relationship with organ damage, including kidney, liver, heart, and bone health, were also been assessed. Results: Among the 449 participants (median age 30 years; 92.9% male), 16.9% met the criteria for MetS. Patients met MetS criteria in our study presented with low HDL-C concentration (49.8%), hypertriglyceridemia (26.1%), hypertension (23.1%), hyperglycemia (15.4%), and abdominal obesity (8.0%). Risk factors significantly associated with MetS included older age (OR 1.08; 95% CI 1.02-1.15) and alcohol consumption (OR 3.63; 95% CI 1.13-11.67). PLWH with MetS exhibited higher level of organ involvement, including reduced kidney function, elevated liver enzymes, and increased risks for cardiovascular events. Among them, 162 participants (36.0%) were classified as being at moderate or high risk using pooled cohort equations (PCEs). It is worth noting that in the MetS group, the dropped bone mineral density (BMD) in the spine decreased more significantly than that of the non-MetS group (P= 0.007). Conclusion: The incidence of MetS in ART-naïve PLWH in China is relatively high. Older age and alcohol consumption are associated with higher risk of MetS. Multiple organ damage may occur accompanied with MetS. Early identification and intervention are critical in managing MetS in PLWH.

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Metabolic dysfunction, rather than obesity, is a risk factor for chronic kidney disease in Chinese population

Cited by 4 publications

References 53 publications

The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016

The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016

The heart rate non-dipping pattern was associated with target organ damage in patients with chronic kidney disease

Prevalence of Metabolic Syndrome in People Living with HIV and its multi-organ damage: A prospective cohort study

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