Whether longitudinal changes in metabolic status influence the effect of kidney stones on cardiovascular disease (CVD) remains unclarified. We investigated the modification effect of status changes in metabolic syndrome (MetS) in the association of kidney stones with risk of incident CVD events.
We performed a prospective association and interaction study in a nationwide cohort including 129,172 participants aged ≥ 40 years without CVDs at baseline and followed up for an average of 3.8 years. Kidney stones information was collected by using a questionnaire and validated by medical records. The repeated biochemical measurements were performed to ascertain the metabolic status at both baseline and follow-up.
4,017 incident total CVDs, 1,413 coronary heart diseases (CHDs) and 2,682 strokes were documented and ascertained during follow-up. Kidney stones presence was significantly associated with 44%, 70% and 31% higher risk of CVDs, CHDs and stroke, respectively. The stratified analysis showed significant associations were found in the incident and sustained MetS patients, while no significant associations were found in the non-MetS at both baseline and follow-up subjects or the MetS remission ones, especially in women. For the change status of each single component of the MetS, though the trends were not always the same, the associations with CVD were consistently significant in those with sustained metabolic disorders, except for the sustained high blood glucose group, while the associations were consistently significant in those with incident metabolic disorders except for the incident blood pressure group. We also found a significant association of kidney stone and CVD or CHD risk in the remain normal glucose or triglycerides groups; while the associations were consistently significant in those with incident metabolic disorders except for the incident blood pressure group. We also found a significant association of kidney stone and CVD or CHD risk in the remain normal glucose or triglycerides groups.
A history of kidney stones in women with newly developed MetS or long-standing MetS associated with increased risk of CVD. The mechanisms link kidney stones and CVD risk in the metabolic and non-metabolic pathways were warranted for further studies.
Frontiers in cardiovascular medicine. 2022 Jul 26*** epublish ***
Min Xu, Zhiyun Zhao, Feixia Shen, Ruying Hu, Jieli Lu, Yu Xu, Tiange Wang, Mian Li, Gang Chen, Li Chen, Lulu Chen, Yuhong Chen, Huacong Deng, Zhengnan Gao, Yanan Huo, Qiang Li, Chao Liu, Zuojie Luo, Yiming Mu, Guijun Qin, Yingfen Qin, Lixin Shi, Qing Su, Qin Wan, Guixia Wang, Shuangyuan Wang, Youmin Wang, Shengli Wu, Yiping Xu, Li Yan, Tao Yang, Zhen Ye, Xuefeng Yu, Yinfei Zhang, Jiajun Zhao, Tianshu Zeng, Weiqing Wang, Yufang Bi, Xulei Tang, Guang Ning
Department of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China., Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China., Institute of Chronic Disease, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China., Department of Endocrinology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China., Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China., Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China., Department of Endocrinology, Dalian Municipal Central Hospital, Dalian, China., Department of Endocrinology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China., Department of Endocrinology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China., Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China., Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China., Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China., Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China., Department of Endocrinology, Affiliated Hospital of Guiyang Medical College, Guiyang, China., Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China., Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China., Department of Endocrinology, The First Hospital of Jilin University, Changchun, China., Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, China., Department of Endocrinology, Karamay Municipal People's Hospital, Xinjiang, China., Clinical Trials Center, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China., Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China., Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Department of Endocrinology, Central Hospital of Shanghai Jiading District, Shanghai, China., Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China., Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, China.