Impact of metabolic syndrome traits on kidney disease Risk in individuals with MASLD: a UK Biobank study
Impact of metabolic syndrome traits on kidney disease Risk in individuals with MASLD: a UK Biobank study
Background and Aims: The impact of metabolic syndrome (MetS) traits on chronic kidney disease (CKD) risk in metabolic dysfunction-associated steatotic liver disease (MASLD) is unknown. We investigated the impact of type and number of MetS traits and liver fibrosis on prevalent CKD and incident end-stage renal disease (ESRD) risk in SLD. Methods: 234 488 UK Biobank participants' were analysed. Hepatic steatosis index (> 36 for SLD, < 30 for no SLD) and MRI-proton density fat fraction (≥ 5.56%) were used to identify SLD. MetS traits were identified using MASLD criteria. Advanced fibrosis (FIB-4 score > 2.67) was determined using FIB-4 scores. eGFR < 60 mL/min/1.73 m
2 or albuminuria > 3 mg/mmol identified prevalent CKD. A validated algorithm identified incident ESRD. Binary logistic and Cox regressions were used to test associations with prevalent CKD ([adjusted odds ratios (ORs)]) and incident ESRD (adjusted hazard ratios [HRs]) respectively. Results: 102 410 participants (41.2%) had SLD. 64.4% had MetS. 1.3% had FIB-4 score > 2.67. With SLD and only one MetS trait, hypertension (OR 1.35, 95% CI 1.35–1.72) or type 2 diabetes (T2D) (OR 1.89, 95% CI 1.06–3.38) increased risk of prevalent CKD. MetS (≥ 3 traits) increased prevalent CKD risk (OR 1.94, 95% CI 1.75–2.15), which was further increased by advanced liver fibrosis (OR 4.29, 95% CI 3.36–5.47). CKD prevalence increased with increasing MetS traits. Over 13.6 years (median follow-up), MetS was associated with increased risk of developing ESRD (HR 1.70, 95% CI 1.19–2.43). Conclusions: In MASLD, hypertension, and T2D, number of MetS traits and liver fibrosis increased risk of prevalent CKD and presence of MetS increased the risk of incident ESRD.
end-stage renal disease, hypertension, metabolic dysfunction-associated steatotic liver disease, type 2 diabetes
Bilson, Josh
a99f9320-335c-47c8-bf30-07df48a5467d
Hydes, Theresa J.
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McDonnell, Declan
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Buchanan, Ryan M.
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Scorletti, Eleonora
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Mantovani, Alessandro
7078d76a-93d7-4177-9542-10e38794bbf2
Targher, Giovanni
ebb870c6-a0dd-427d-9fa8-bb850a538986
Byrne, Chrisopher D.
1370b997-cead-4229-83a7-53301ed2a43c
April 2025
Bilson, Josh
a99f9320-335c-47c8-bf30-07df48a5467d
Hydes, Theresa J.
dbe27497-a1d8-4dcd-ad66-91e31f2db881
McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Buchanan, Ryan M.
9499f713-f684-4046-be29-83cd9d6f834d
Scorletti, Eleonora
4e896544-2974-4f81-9696-1595d3c36814
Mantovani, Alessandro
7078d76a-93d7-4177-9542-10e38794bbf2
Targher, Giovanni
ebb870c6-a0dd-427d-9fa8-bb850a538986
Byrne, Chrisopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Bilson, Josh, Hydes, Theresa J., McDonnell, Declan, Buchanan, Ryan M., Scorletti, Eleonora, Mantovani, Alessandro, Targher, Giovanni and Byrne, Chrisopher D.
(2025)
Impact of metabolic syndrome traits on kidney disease Risk in individuals with MASLD: a UK Biobank study.
Liver International, 45 (4), [e16159].
(doi:10.1111/liv.16159).
Abstract
Background and Aims: The impact of metabolic syndrome (MetS) traits on chronic kidney disease (CKD) risk in metabolic dysfunction-associated steatotic liver disease (MASLD) is unknown. We investigated the impact of type and number of MetS traits and liver fibrosis on prevalent CKD and incident end-stage renal disease (ESRD) risk in SLD. Methods: 234 488 UK Biobank participants' were analysed. Hepatic steatosis index (> 36 for SLD, < 30 for no SLD) and MRI-proton density fat fraction (≥ 5.56%) were used to identify SLD. MetS traits were identified using MASLD criteria. Advanced fibrosis (FIB-4 score > 2.67) was determined using FIB-4 scores. eGFR < 60 mL/min/1.73 m
2 or albuminuria > 3 mg/mmol identified prevalent CKD. A validated algorithm identified incident ESRD. Binary logistic and Cox regressions were used to test associations with prevalent CKD ([adjusted odds ratios (ORs)]) and incident ESRD (adjusted hazard ratios [HRs]) respectively. Results: 102 410 participants (41.2%) had SLD. 64.4% had MetS. 1.3% had FIB-4 score > 2.67. With SLD and only one MetS trait, hypertension (OR 1.35, 95% CI 1.35–1.72) or type 2 diabetes (T2D) (OR 1.89, 95% CI 1.06–3.38) increased risk of prevalent CKD. MetS (≥ 3 traits) increased prevalent CKD risk (OR 1.94, 95% CI 1.75–2.15), which was further increased by advanced liver fibrosis (OR 4.29, 95% CI 3.36–5.47). CKD prevalence increased with increasing MetS traits. Over 13.6 years (median follow-up), MetS was associated with increased risk of developing ESRD (HR 1.70, 95% CI 1.19–2.43). Conclusions: In MASLD, hypertension, and T2D, number of MetS traits and liver fibrosis increased risk of prevalent CKD and presence of MetS increased the risk of incident ESRD.
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Liver International - 2024 - Bilson - Impact of Metabolic Syndrome Traits on Kidney Disease Risk in Individuals with MASLD
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Accepted/In Press date: 27 October 2024
e-pub ahead of print date: 15 November 2024
Published date: April 2025
Keywords:
end-stage renal disease, hypertension, metabolic dysfunction-associated steatotic liver disease, type 2 diabetes
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Local EPrints ID: 496520
URI: http://eprints.soton.ac.uk/id/eprint/496520
ISSN: 1478-3223
PURE UUID: d4e22dc4-394b-411e-9981-0422de130960
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Date deposited: 17 Dec 2024 17:41
Last modified: 11 Oct 2025 02:19
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Author:
Josh Bilson
Author:
Theresa J. Hydes
Author:
Declan McDonnell
Author:
Eleonora Scorletti
Author:
Alessandro Mantovani
Author:
Giovanni Targher
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