Objective: To investigate the relationships between dynamic changes in metabolic syndrome (MetS) components and chronic kidney disease (CKD) risk.

Methods: Data from the UK Biobank, including baseline assessments from 2006 to 2010, repeat assessments in 2012-2013, and linked national health records, were analyzed. MetS components consisted of abdominal obesity, elevated blood pressure (BP), fasting blood glucose (FBG), serum uric acid (SUA), and lipid abnormalities. The Kaplan-Meier method and log-rank test were used to analyze CKD incidence and group differences. Cox regression models assessed the association between dynamic changes in MetS components and CKD risk.

Results: The study enrolled 455,060 participants (45.7% male, 18.4% aged 65 years or older) with a median follow-up of 12.68 years. Those with MetS had a significantly higher 10-year CKD cumulative incidence probability of CKD than those without MetS (4.14% VS 1.14%). Multivariate analysis showed all baseline metabolic abnormalities were linked to CKD risk with HRs from 1.40(1.35-1.45) to 1.85 (1.78-1.92), and MetS strongly associated with CKD (HR: 2.31). CKD risk rose with more MetS components and progression stages. Notably, with FBG being the exception, the four MetS components that shifted from normal at baseline to abnormal at follow - up were associated with elevated CKD risk, with HRs (95% CI) ranging from 1.21 (1.00-1.48) to 1.73 (1.34-2.24). Participants with high baseline SUA, even if it normalized at follow - up, still faced a 1.30 - fold higher CKD risk (95% CI: 1.25-1.35), distinct from other components. For those developing one and ≥ 2 new MetS components at follow - up, the CKD risk HRs (95% CI) were 1.49 (1.00-2.35) and 2.26 (1.21-4.24) respectively.

Conclusion: MetS and its component changes are significantly associated with CKD risk, in a dose - response pattern. Incorporating SUA into MetS assessments enhances risk identification, especially noting females' higher susceptibility to elevated SUA. Dynamic monitoring of MetS components is crucial for assessing and predicting CKD risk.

Clinical trial number: Not applicable.

Keywords: Chronic kidney disease; Cohort study; Dynamic changes; Metabolic syndrome; UK biobank.

© 2025. The Author(s).

目的：研究代谢综合征（MetS）组分的动态变化与慢性肾脏病（CKD）风险之间的关系。

方法：分析了来自英国生物银行的数据，包括2006年至2010年的基线评估、2012-2013年的重复评估以及链接的国家健康记录。代谢综合征组分包括腹部肥胖、高血压（BP）、空腹血糖（FBG）、血清尿酸（SUA）和脂质异常。使用Kaplan-Meier方法和log-rank检验来分析CKD发病率及组间差异。Cox回归模型评估了MetS组分的动态变化与CKD风险之间的关联。

结果：本研究共纳入455,060名参与者（男性占45.7%，年龄≥65岁的占18.4%），中位随访时间为12.68年。患有代谢综合征的参与者比没有代谢综合征的人在十年内CKD累积发病率显著较高（4.14% VS 1.14%）。多变量分析显示，所有基线代谢异常均与CKD风险相关，HR值从1.40(1.35-1.45)到1.85 (1.78-1.92)，而代谢综合征与CKD高度相关（HR：2.31）。随着代谢综合征组分数量的增加和进展阶段的提升，CKD风险亦随之升高。值得注意的是，除了空腹血糖以外，从基线到随访期间由正常变为异常的所有四个MetS组分均与升高的CKD风险有关，HR值（95% CI）范围为1.21 (1.00-1.48) 至 1.73 (1.34-2.24)。基线血清尿酸水平较高的参与者即使在随访期间恢复正常，仍面临1.30倍的CKD风险（95% CI: 1.25-1.35），与其它组分不同。对于那些随访时发展出一个及≥2个新的MetS组分的人来说，其CKD风险HR值（95% CI）分别为1.49 (1.00-2.35) 和 2.26 (1.21-4.24)。

结论：代谢综合征及其组分的变化与CKD风险呈显著的剂量反应关系。将血清尿酸纳入代谢综合征评估中可以提高识别风险，特别是要注意女性对高血清尿酸水平的易感性。动态监测MetS组分对于评估和预测CKD风险至关重要。

临床试验编号：不适用。

关键词：慢性肾脏病；队列研究；动态变化；代谢综合征；英国生物银行。