Change in Metabolic Health Status Over Time and Risk of Chronic Kidney Disease: A Prospective Study
Abstract Objective: Metabolically healthy obesity (MHO) is a dynamic condition and is known to increase the risk for chronic kidney disease (CKD). In this study, we aimed to examine the association between metabolic health status and its change over time and CKD risk.Methods: A total of 39463 participants from Kailuan Study were collected body mass index and metabolic health status at 2006/07 and 2010/11 examination. Metabolic abnormality was diagnosed by the presence of any 2 of 4 components (elevated blood pressure, elevated fasting blood glucose, elevated triglyceride and decreased high-density lipoprotein cholesterol). We classified participants into six groups according to metabolic health status and obesity. The changes in obesity and metabolic health status were considered from 2006/07 to 2010/11. Results: Of the participants classified as MHNW or MHO at baseline, 17.25% and 39.64% were classified as MUNW or MUO in 2010/11, respectively. During a mean follow-up of 9.7 years, 5351 participants developed CKD from 2010/11. Compared with participants in the stable MHNW group, the stable MHO group had a significantly higher risk of incident CKD (HR: 1.16; 95% CI: 1.02-1.33), but was lower than that in individuals with MUO. Individuals with metabolic healthy at baseline who changed to metabolic abnormality during follow-up had higher risk of CKD. Conclusions: MHO phenotype or its transition to a metabolically unhealthy phenotype were associated with increased risk of CKD. Stable metabolic health individuals had lower risk of CKD than those with metabolically unhealthy phenotype.