Zhao Naihui, Zhang Yinggen, Liu Peipei, Zhang Xiaofu, Zhang Zihao, Ou Wenli, Dong Ao, Chang Yanhe, Chen Shuohua, Wang Guodong, Wu Shouling, Yang Xiuhong
School of Public Health, North China University of Science and Technology, Caofeidian Eco-city, Tangshan, Hebei, China.
Department of Nuclear Medicine, Kailuan General Hospital, Tangshan, Hebei, China.
Endocrine. 2025 Apr;88(1):99-109. doi: 10.1007/s12020-024-04119-1. Epub 2024 Nov 30.
Metabolic syndrome (MetS) is an independent risk factor for new-onset and progression of chronic kidney disease (CKD). However, whether changes in MetS are associated with the new-onset CKD and its progression remains unknown.
A total of 36,571 participants from the Kailuan Study were enrolled in this study, including 27,072 without CKD and 9499 with CKD at baseline. According to the changes of MetS, 4 groups were divided as follows: MetS-free group, MetS-recovered group, MetS-developed group, and MetS-persistent group. Cox regression models were used to explore the association of changes in MetS with new-onset and progression of CKD.
During a median follow-up of 8.38 years, 3313 cases of new-onset CKD were identified in participants without CKD. Compared with the MetS-free group, the hazard ratio (HR) and 95% confidence interval (95% CI) for new-onset CKD in the MetS-recovered, MetS-developed and MetS-persistent groups was 1.34 (1.18-1.53), 1.46 (1.30-1.63) and 1.85 (1.69-2.02), respectively. Among 9499 participants with CKD, during a median follow-up of 8.18 years, a total of 2305 experienced CKD progression. Compared with the MetS-free group, the HR (95% CI) for CKD progression in each group were 1.05 (0.91-1.22), 1.34 (1.17-1.55) and 1.65 (1.49-1.83), respectively. Furthermore, the association between changes in MetS and new-onset CKD was stronger in younger and middle-aged participants (≤60 years old) compared with older participants.
Developed MetS and persistent MetS were both risk factors for the new-onset and progression of CKD. Even with recovery from MetS, an association of MetS with kidney damage remained.
代谢综合征（MetS）是慢性肾脏病（CKD）新发和进展的独立危险因素。然而，MetS的变化是否与CKD的新发及其进展相关仍不清楚。
本研究纳入了开滦研究中的36571名参与者，其中27072名在基线时无CKD，9499名有CKD。根据MetS的变化，分为以下4组：无MetS组、MetS恢复组、MetS发生组和MetS持续组。采用Cox回归模型探讨MetS变化与CKD新发和进展的关联。
在中位随访8.38年期间，无CKD的参与者中确诊了3313例新发CKD。与无MetS组相比，MetS恢复组、MetS发生组和MetS持续组新发CKD的风险比（HR）及95%置信区间（95%CI）分别为1.34（1.18-1.53）、1.46（1.30-1.63）和1.85（1.69-2.02）。在9499名有CKD的参与者中，中位随访8.18年期间，共有2305例出现CKD进展。与无MetS组相比，各组CKD进展的HR（95%CI）分别为1.05（0.91-1.22）、1.34（1.17-1.55）和1.65（1.49-1.83）。此外，与老年参与者相比，MetS变化与新发CKD之间的关联在中青年参与者（≤60岁）中更强。
发生MetS和持续存在MetS均是CKD新发和进展的危险因素。即使MetS恢复，MetS与肾脏损害之间的关联仍然存在。
