Diabetology & metabolic syndrome · 2026
Association between different metabolic phenotypes and chronic kidney disease risk: a cohort study.
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Yu Qi, Xu Haolan, Yang Qin, Wang Wenjing, Zhou Ru, Yang Yanlang
Аннотация
INTRODUCTION: Metabolic syndrome (MetS) involves conditions that alter renal structure/function; however few studies have considered the dynamic nature of metabolic status when exploring its association with chronic kidney disease (CKD).
METHODS: We retrospectively included 7034 participants, categorized into four metabolic phenotypes by BMI and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically unhealthy non-overweight/obesity (MUNO), and metabolically unhealthy overweight/obesity (MUO). The primary endpoint was incident CKD (eGFR < 60 ml/min/1.73 m² and/or proteinuria for two consecutive years). Associations were assessed using Cox and logistic regression analysis with multivariate adjustments.
RESULTS: The baseline proportions of individuals with MHNO, MUNO, MHO, and MUO phenotypes were 35.6%, 17.5%, 18.3%, and 28.6%, respectively. After multivariate adjustment in Cox analyses, MUNO (HR:1.184; 95%CI:1.031-1.506) and MUO (HR:1.420; 95%CI:1.153-1.749) phenotypes were associated with incident CKD, with no such association in the MHO phenotype. However, in terms of transitions, compared with those with a consistent MHNO phenotype, those with a MHO phenotype evolving to a metabolically unhealthy status had higher incident CKD risk (HR:1.649; 95%CI:1.096-2.482).
CONCLUSION: Overweight/obesity and metabolic unhealthy status increase CKD risk; individuals with MHO who transition to metabolically unhealthy phenotypes have higher CKD risk than those consistently maintaining MHNO.
METHODS: We retrospectively included 7034 participants, categorized into four metabolic phenotypes by BMI and metabolic status: metabolically healthy non-overweight/obesity (MHNO), metabolically healthy overweight/obesity (MHO), metabolically unhealthy non-overweight/obesity (MUNO), and metabolically unhealthy overweight/obesity (MUO). The primary endpoint was incident CKD (eGFR < 60 ml/min/1.73 m² and/or proteinuria for two consecutive years). Associations were assessed using Cox and logistic regression analysis with multivariate adjustments.
RESULTS: The baseline proportions of individuals with MHNO, MUNO, MHO, and MUO phenotypes were 35.6%, 17.5%, 18.3%, and 28.6%, respectively. After multivariate adjustment in Cox analyses, MUNO (HR:1.184; 95%CI:1.031-1.506) and MUO (HR:1.420; 95%CI:1.153-1.749) phenotypes were associated with incident CKD, with no such association in the MHO phenotype. However, in terms of transitions, compared with those with a consistent MHNO phenotype, those with a MHO phenotype evolving to a metabolically unhealthy status had higher incident CKD risk (HR:1.649; 95%CI:1.096-2.482).
CONCLUSION: Overweight/obesity and metabolic unhealthy status increase CKD risk; individuals with MHO who transition to metabolically unhealthy phenotypes have higher CKD risk than those consistently maintaining MHNO.