Obesity, Abdominal Obesity and Chronic Kidney Disease in Young Adults: A Nationwide Population-Based Cohort Study

Obesity has become a pandemic. It is one of the strongest risk-factors of new-onset chronic kidney disease (CKD). However, the effects of obesity and abdominal obesity on the risk of developing CKD in young adults has not been elucidated. From a nationwide health screening database, we included 3,030,884 young adults aged 20–39 years without CKD during a baseline examination in 2009–2010, who could follow up during 2013–2016. Patients were stratified into five levels based on their baseline body mass index (BMI) and six levels based on their waist circumference (WC; 5-cm increments). The primary outcome was the development of CKD. During the follow up, until 2016, 5853 (0.19%) participants developed CKD. Both BMI and WC showed a U-shaped relationship with CKD risk, identifying the cut-off values as a BMI of 21 and WC of 72 cm in young adults. The obesity group (odd ratio [OR] = 1.320, 95% confidence interval [CI]: 1.247–1.397) and abdominal obesity group (male WC ≥ 90, female WC ≥ 85) (OR = 1.208, 95%CI: 1.332–1.290) showed a higher CKD risk than the non-obesity or non-abdominal obesity groups after adjusting for covariates. In the CKD risk by obesity composite, the obesity displayed by the abdominal obesity group showed the highest CKD risk (OR = 1.502, 95%CI: 1.190–1.895), especially in those under 30 years old. During subgroup analysis, the diabetes mellitus (DM) group with obesity or abdominal obesity paradoxically showed a lower CKD risk compared with the non-obesity or non-abdominal obesity group. Obesity and abdominal obesity are associated with increased risk of developing CKD in young adults but a decreased risk in young adults with diabetes.

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Dietary Micronutrients and Risk of Chronic Kidney Disease: A Cohort Study with 12 Year Follow-Up

Nutrients ◽

10.3390/nu13051517 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1517

Author(s):

Juyeon Lee ◽

Kook-Hwan Oh ◽

Sue-Kyung Park

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Epidemiologic Study ◽

Population Based ◽

Dietary Guidelines ◽

Dietary Intakes ◽

Increased Risk ◽

Ckd Stage

We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.

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Preeclampsia and the risk of chronic kidney disease: a national registry-based cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1174 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P M Barrett ◽

F P McCarthy ◽

M Evans ◽

M Kublickas ◽

I J Perry ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Absolute Risk ◽

Population Based ◽

National Registry ◽

Medical Birth Register ◽

Increased Risk ◽

History Of

Abstract Background Preeclampsia is associated with increased risk of future cardiovascular disease, but evidence for associations with chronic kidney disease (CKD) has been inconsistent to date. We aimed to measure associations between preeclampsia and long-term CKD in a population-based sample of parous women, and to identify whether the risk differs by CKD subtype. Methods Using data from the Swedish Medical Birth Register, singleton live births from 1973-2012 were identified and linked to data from the Swedish Renal Register and National Patient Register (up to 2013). Preeclampsia was the main exposure of interest and was treated as a time-dependent variable. The primary outcome was maternal CKD, and this was classified into 5 subtypes: hypertensive, diabetic, glomerular/proteinuric, tubulo-interstitial, other/non-specific CKD. Cox proportional hazard regression models were used for analysis. Women with pre-pregnancy comorbidities were excluded. Results The dataset included 1,924,591 unique women who had 3,726,819 singleton pregnancies. The median follow-up was 20.7 (interquartile range 9.9-30.0) years. Overall, 90,964 women (4.7%) experienced preeclampsia and 18,146 (0.9%) developed CKD. Women who had preeclampsia had higher risk of developing any CKD during follow-up (aHR 1.88, 95% CI 1.79-1.98). The risk differed by CKD subtype, and was higher for hypertensive CKD (aHR 3.76, aHR 3.09-4.57), diabetic CKD (aHR 3.45, 95% CI 2.83-4.21) and glomerular/proteinuric CKD (aHR 2.08, 95% CI 1.90-2.29). Women who had preterm preeclampsia, recurrent preeclampsia, or preeclampsia complicated by pre-pregnancy obesity were also at greater risk of any CKD. Conclusions Women with a history of preeclampsia are at increased risk of long-term CKD. The risk is most marked for hypertensive CKD, diabetic CKD, and glomerular/proteinuric CKD. The absolute risk of CKD related to preeclampsia is substantial, and these women may warrant systematic renal monitoring in the years following delivery. Key messages Preeclampsia is an independent predictor of long-term risk of chronic kidney disease in otherwise healthy parous women. Women with a history of preeclampsia may warrant systematic renal monitoring through additional blood pressure, blood glucose, and proteinuria checks.

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Fibroblast growth factor 23 and new-onset chronic kidney disease in the general population: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfz266 ◽

2020 ◽

Vol 36 (1) ◽

pp. 121-128 ◽

Cited By ~ 1

Author(s):

Maarten A De Jong ◽

Michele F Eisenga ◽

Adriana J van Ballegooijen ◽

Joline W J Beulens ◽

Marc G Vervloet ◽

...

Keyword(s):

Risk Factors ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Fibroblast Growth Factor 23 ◽

Population Based ◽

Fibroblast Growth ◽

Fgf23 Level ◽

Increased Risk ◽

All Cause Mortality ◽

New Onset

Abstract Background Fibroblast growth factor 23 (FGF23), a phosphate-regulating hormone that increases early in the course of chronic kidney disease (CKD), is associated with disease progression in patients with established CKD. Here we aimed to investigate the association between plasma FGF23 and new-onset CKD in the general population. Methods We included 5253 individuals without CKD who participated in the Prevention of Renal and Vascular Endstage Disease study, a prospective, population-based cohort. Multi-variable Cox regression was used to study the association of plasma C-terminal FGF23 with new-onset CKD, defined as a combined endpoint of estimated glomerular filtration rate (eGFR) <60 mL/min/ 1.73 m2, urinary 24-h albumin excretion (UAE) >30 mg/24 h or both, or with all-cause mortality. Results The median baseline FGF23 was 68 [interquartile range (IQR) 56–85] RU/mL, eGFR was 95 ± 13 mL/min/1.73 m2 and UAE was 7.8 (IQR 5.8–11.5) mg/24 h. After follow-up of 7.5 (IQR 7.2–8.0) years, 586 participants developed CKD and 214 participants died. A higher FGF23 level was associated with new-onset CKD, independent of risk factors for kidney disease and parameters of bone and mineral homoeostasis {fully adjusted hazard ratio (HR) 1.25 [95% confidence interval (CI) 1.10–1.44] per doubling of FGF23; P = 0.001}. In secondary analyses, FGF23 was independently associated with new-onset eGFR <60 mL/min/1.73 m2 [adjusted HR 1.28 (95% CI 1.00–1.62); P = 0.048] or with UAE >30 mg/24 h [adjusted HR 1.24 (95% CI 1.06–1.45); P = 0.01] individually. A higher FGF23 level was also associated with an increased risk of all-cause mortality [fully adjusted HR 1.30 (95% CI 1.03–1.63); P = 0.03]. Conclusions High FGF23 levels are associated with an increased risk of new-onset CKD and all-cause mortality in this prospective population-based cohort, independent of established CKD risk factors.

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Abstract 79: Evidence to Maintain the SBP treatment threshold at 140 mmHg for Stroke Prevention in Persons Aged 60 Years or Older Without Diabetes Mellitus or Chronic Kidney Disease: The Northern Manhattan Study (NOMAS)

Stroke ◽

10.1161/str.46.suppl_1.79 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Chuanhui Dong ◽

Tatjana Rundek ◽

Chensy Marquez ◽

Clinton B Wright ◽

Mitchell S Elkind ◽

...

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Stroke Risk ◽

Medication Use ◽

Population Based ◽

National Committee ◽

Stroke Incidence ◽

Increased Risk

Background: In 2014, the Eighth Joint National Committee recommended increasing target systolic blood pressure (SBP) from 140 to 150 mm Hg in persons aged ≥ 60 years without diabetes mellitus (DM) or chronic kidney disease (CKD). The evidence from population-based studies supporting the change was sparse. In a race/ethnically diverse prospective cohort, we examined incident stroke risk by SBP level in those aged ≥ 60 years without stroke, DM, or CKD at baseline. Methods: In the Northern Manhattan Study, there were 1706 participants aged ≥ 60 years and free of stroke, DM, and CKD at baseline. Incident strokes were identified through annual follow-up and adjudicated by two vascular neurologists. Cox proportional hazard models were used to estimate the multivariable-adjusted hazard ratio (HR) for baseline SBP categories and stroke risk. Results: At baseline, mean age was 72±8 years, 37% were male, 25% non-Hispanic white, 26% non-Hispanic black, and 49% Hispanic; 41% were on antihypertensive medication, and 43% had SBP <140 mm Hg, 20% 140-149 mm Hg, and 37% ≥150 mm Hg. With a median follow-up of 13 years, 167 participants developed a stroke. The crude stroke incidence was greater among individuals with SBP ≥150 mm Hg (10.0 per 1000 person-years) and SBP 140-149 (12.2) compared to those with SBP<140 (6.2). After adjustment for age, sex, race-ethnicity and medication use, participants with SBP 140-149 mm Hg had increased risk of stroke (HR, 1.7; 95% CI, 1.2-2.6) compared with those with SBP <140 mm Hg, and the increased risk remained in those without medication use (1.7; 1.0-3.0). Stratified analysis showed that the increased risk was seen in Hispanics (2.4; 1.3-4.7) and non-Hispanic blacks (2.0; 1.0-4.2) but not in non-Hispanic whites (0.8; 0.3-1.8). Conclusions: In a prospective diverse cohort, SBP 140-149 mm Hg was associated with an increased stroke risk, compared to those with SBP <140 mm Hg, in individuals aged 60 years or older without DM or CKD, in particular in Hispanics and non-Hispanic blacks. Raising the threshold for hypertension treatment could have a detrimental effect on stroke risk reduction especially among minority populations.

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Chronic kidney disease and the risk of incident renal and urothelial cancer in a population-based cohort of 1.2 million adults.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.5_suppl.351 ◽

2012 ◽

Vol 30 (5_suppl) ◽

pp. 351-351

Author(s):

William Thomas Lowrance ◽

Natalia Udaltsova ◽

Juan Ordoñez ◽

Paul Russo ◽

Alan S. Go

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Cancer Risk ◽

Urothelial Cancer ◽

Population Based ◽

Incident Cancer ◽

Increased Risk ◽

Lower Egfr ◽

Risk Of Cancer

351 Background: Prior studies have observed an increased risk of cancer in patients with end stage renal disease, but whether less severe chronic kidney disease influences the risk of cancer is uncertain. Methods: Among 1,190,538 adults at least 40 years of age and no prior dialysis, renal transplant or known cancer who received care within Kaiser Permanente Northern California, we examined the independent association between estimated glomerular filtration rate (eGFR) and the risk of cancer, overall and by type, between 2000 and 2008. Incident cancers were identified from a comprehensive regional cancer registry and potential confounders were ascertained using validated algorithms based on health plan electronic medical records. The impact of time-varying eGFR on incident cancer risk was examined using multivariable extended Cox regression, after excluding any cancers detected during the first two years of follow-up and any eGFR values within 3 months before a cancer diagnosis to reduce potential biases. Results: During 6,000,420 person-years of follow-up, 76,809 incident cancer diagnoses were identified among 72,875 patients (38,744 M, 34,131 F). After adjustment for possible confounding factors, the risk of renal cancer increased with lower eGFR (ml/min/1.73 m2): the adjusted hazard ratio [HR] for renal cancer was 1.35 (95% CI: 1.18–1.55) for eGFR 45–59, HR 1.65 (1.37 to 1.97) for eGFR 30–44, and HR 2.09 (1.62 to 2.70) for eGFR <30. There was a similar association between eGFR and urothelial cancer. However, there was not a significant multivariable association between eGFR and prostate, colorectal, lung, breast, or any cancer. Conclusions: We observed a graded, independent increased risk of renal and urothelial cancer risk with lower eGFR in a large, population-based cohort. However, lower eGFR was not significantly associated with other major cancer types. Additional research is needed to understand potential contributing mechanisms between reduced renal function and renal or urothelial malignancies, as well as whether differential cancer screening strategies are effective in patients with chronic kidney disease.

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Association of Body Weight Variability with Adverse Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Nutrients ◽

10.3390/nu13103381 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3381

Author(s):

Sang Heon Suh ◽

Tae Ryom Oh ◽

Hong Sang Choi ◽

Chang Seong Kim ◽

Eun Hui Bae ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Body Weight ◽

Kidney Disease ◽

Primary Outcome ◽

Body Weight Gain ◽

Absolute Difference ◽

Composite Outcome ◽

Increased Risk ◽

All Cause Mortality

To investigate the association of body weight variability (BWV) with adverse cardiovascular (CV) outcomes in patient with pre-dialysis chronic kidney disease (CKD), a total of 1867 participants with pre-dialysis CKD from Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) were analyzed. BWV was defined as the average absolute difference between successive values. The primary outcome was a composite of non-fatal CV events and all-cause mortality. Secondary outcomes were fatal and non-fatal CV events and all-cause mortality. High BWV was associated with increased risk of the composite outcome (adjusted hazard ratio (HR) 1.745, 95% confidence interval (CI) 1.065 to 2.847) as well as fatal and non-fatal CV events (adjusted HR 1.845, 95% CI 1.136 to 2.996) and all-cause mortality (adjusted HR 1.861, 95% CI 1.101 to 3.145). High BWV was associated with increased risk of fatal and non-fatal CV events, even in subjects without significant body weight gain or loss during follow-up periods (adjusted HR 2.755, 95% CI 1.114 to 6.813). In conclusion, high BWV is associated with adverse CV outcomes in patients with pre-dialysis CKD.

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Association of chronic kidney disease with mortality risk in patients with lung cancer: a nationwide Taiwan population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2017-019661 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019661 ◽

Cited By ~ 7

Author(s):

Yu-Feng Wei ◽

Jung-Yueh Chen ◽

Ho-Shen Lee ◽

Jiun-Ting Wu ◽

Chi-Kuei Hsu ◽

...

Keyword(s):

Lung Cancer ◽

Chronic Kidney Disease ◽

Cohort Study ◽

Kidney Disease ◽

Renal Disease ◽

Mortality Risk ◽

Population Based ◽

Research Database ◽

Cox Regression Analysis ◽

Increased Risk

ObjectiveOur population-based research aimed to clarify the association between chronic kidney disease (CKD) and mortality risk in patients with lung cancer.DesignRetrospective cohort studySettingNational health insurance research database in TaiwanParticipantsAll (n=1 37 077) Taiwanese residents who were diagnosed with lung cancer between 1997 and 2012 were identified. Eligible patients with baseline CKD (n=2269) were matched with controls (1:4, n=9076) without renal disease according to age, sex and the index day of lung cancer diagnosis.MethodsThe cumulative incidence of death was calculated by the Kaplan-Meier method, and the risk determinants were explored by the Cox proportional hazards model.ResultsMortality occurred in 1866 (82.24%) and 7135 (78.61%) patients with and without CKD, respectively (P=0.0001). The cumulative incidences of mortality in patients with and without chronic renal disease were 72.8% vs 61.6% at 1 year, 82.0% vs 76.6% at 2 years and 88.9% vs 87.2% at 5 years, respectively. After adjusting for multiple confounding factors including age and comorbidities, Cox regression analysis revealed that CKD was associated with an increased risk of mortality (adjusted HR 1.38; 95% CI 1.29 to 1.47). Stratified analysis further showed that the association was consistent across patient subgroups.ConclusionComorbidity associated with CKD is a risk factor for mortality in patients with lung cancer.

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Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes

Cardiovascular Diabetology ◽

10.1186/s12933-020-01128-y ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Nam Ju Heo ◽

Sang Youl Rhee ◽

Jill Waalen ◽

Steven Steinhubl

Keyword(s):

Atrial Fibrillation ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Clinical Symptoms ◽

Screening Program ◽

Renal Involvement ◽

Newly Diagnosed ◽

Mortality And Morbidity ◽

Increased Risk

Abstract Background Diabetes is an independent risk factor for atrial fibrillation (AF), which is associated with increases in mortality and morbidity, as well as a diminished quality of life. Renal involvement in diabetes is common, and since chronic kidney disease (CKD) shares several of the same putative mechanisms as AF, it may contribute to its increased risk in individuals with diabetes. The objective of this study is to identify the relationship between CKD and the rates of newly-diagnosed AF in individuals with diabetes taking part in a screening program using a self-applied wearable electrocardiogram (ECG) patch. Materials and methods The study included 608 individuals with a diagnosis of diabetes among 1738 total actively monitored participants in the prospective mHealth Screening to Prevent Strokes (mSToPS) trial. Participants, without a prior diagnosis of AF, wore an ECG patch for 2 weeks, twice, over a 4-months period and followed clinically through claims data for 1 year. Definitions of CKD included ICD-9 or ICD-10 chronic renal failure diagnostic codes, and the Health Profile Database algorithm. Individuals requiring dialysis were excluded from trial enrollment. Results Ninety-six (15.8%) of study participants with diabetes also had a diagnosis of CKD. Over 12 months of follow-up, 19 new cases of AF were detected among the 608 participants. AF was newly diagnosed in 7.3% of participants with CKD and 2.3% in those without (P < 0.05) over 12 months of follow-up. In a univariate Cox proportional hazard regression analysis, the risk of incident AF was 3 times higher in individuals with CKD relative to those without CKD: hazard ratios (HR) 3.106 (95% CI 1.2–7.9). After adjusting for the effect of age, sex, and hypertension, the risk of incident AF was still significantly higher in those with CKD: HR 2.886 (95% CI 1.1–7.5). Conclusion Among individuals with diabetes, CKD significantly increases the risk of incident AF. Identification of AF prior to clinical symptoms through active ECG screening could help to improve the clinical outcomes in individuals with CKD and diabetes.

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Cardiovascular Outcomes in African Americans with Sickle Cell Trait and Chronic Kidney Disease

American Journal of Nephrology ◽

10.1159/000496058 ◽

2019 ◽

Vol 49 (2) ◽

pp. 93-102 ◽

Cited By ~ 3

Author(s):

Kabir O. Olaniran ◽

Nwamaka D. Eneanya ◽

Andrew S. Allegretti ◽

Sophia H. Zhao ◽

Maureen M. Achebe ◽

...

Keyword(s):

Chronic Kidney Disease ◽

African American ◽

Cardiovascular Risk ◽

African Americans ◽

Kidney Disease ◽

Sickle Cell ◽

Sickle Cell Trait ◽

Increased Risk ◽

The Mean

Background: Sickle cell trait (SCT) is common among African Americans and has been historically considered to be benign. Recently, SCT has been associated with an increased risk for chronic kidney disease (CKD) and cardiovascular disease in the general population. Our understanding of SCT has been extrapolated largely from data of patients with sickle cell disease (SCD). Notably, in SCD, the outcomes differ by sex. The effect of SCT on cardiovascular risk in the African American CKD population is unknown, and the interaction between SCT and sex on cardiovascular risk has not been investigated. Methods: We performed a 2-center retrospective cohort study of all African American patients with SCT using international classification of disease diagnosis codes and CKD (using the 2012 Kidney Disease Improving Global Outcomes criteria) with at least 1 year of follow-up between January 2005 and December 2017. A reference group of African American CKD patients without SCT was used as a comparator during the same period. SCT patients and the reference patients were matched at baseline for age, sex, comorbidities, and proteinuria. Primary outcomes were incident coronary artery disease (CAD), incident stroke, and all-cause mortality. Analysis of effect modification between sex and SCT on primary outcomes was performed. Results: We identified 621 African American CKD patients, 217 SCT patients, and 404 reference patients. The mean age was 56 ± 13 years and 66% were female. The mean estimated glomerular filtration rate was 69 ± 30 mL/min. The mean follow-up time was 8 ± 4 years. There were no significant differences in the primary outcomes comparing SCT patients to matched controls. The interaction term between SCT and sex, however, was significant in the CAD model (p < 0.01). Stratification by sex showed no increased risk in females but a significantly increased risk for CAD in male SCT patients (hazard ratio [HR] 2.14; 95% CI 1.18–3.86), which persisted after multivariable analysis (HR 2.13; 95% CI 1.17–3.86). Conclusion: SCT is associated with an increased risk for CAD in African American males with CKD. The excess risk in males with SCT appears to follow the same pattern as risk in males with SCD. Larger studies are needed to confirm these findings.

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Association between handgrip strength and the risk of new-onset metabolic syndrome: a population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2020-041384 ◽

2020 ◽

Vol 10 (10) ◽

pp. e041384

Author(s):

Chao Shen ◽

Jiangting Lu ◽

Zhijie Xu ◽

Yuanyuan Xu ◽

Ying Yang

Keyword(s):

Metabolic Syndrome ◽

Abdominal Obesity ◽

Longitudinal Research ◽

Handgrip Strength ◽

Population Based ◽

Study Data ◽

Simple Index ◽

Increased Risk ◽

Nationally Representative ◽

New Onset

ObjectivesA lower relative handgrip strength (HGS) may disrupt metabolic homeostasis and then lead to metabolic syndrome (MetS). There is a paucity of longitudinal studies to examine whether relative HGS at baseline is linked to incident MetS. Thus, the purpose of the present study was to explore the association between relative HGS and new-onset MetS.DesignThis is an observational and longitudinal research.A nationally representative sample of population in China.ParticipantsA total of 3350 subjects without MetS were selected for analysis in the present study. Data are from the China Health and Retirement Longitudinal Study (2011–2015).Outcome measuresWe calculated the relative HGS by dividing the HGS by body weight. Participants were divided into gender-specific quartiles. We estimated HRs for MetS and its components using Cox proportional hazard models according to the relative HGS categories.ResultsAfter multiple adjustment, the risk of MetS increased with the lower quartile of relative HGS in both sexes. Using the highest quartile (Q4) as a reference, the HR for quartile Q3–1 was 1.49 (0.95, 2.34), 1.67 (1.08, 2.59) and 1.76 (1.12, 2.78), respectively, in men, and 1.14 (0.82, 1.58), 1.30 (1.02, 1.57) and 1.28 (1.03, 1.55), respectively, in women. Additionally, we observed that relative HGS was negatively or inversely associated with the risk of abdominal obesity in both sexes.ConclusionsThe current study demonstrated that relative HGS was inversely and independently associated with an increased risk of MetS and abdominal obesity, suggesting a possible role of relative HGS as a useful and simple index for muscle strength in the prediction of occurrence of MetS.

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