AUTHOR=Kwon Soonil , Lee So-Ryoung , Choi Eue-Keun , Lee Seung-Woo , Jung Jin-Hyung , Han Kyung-Do , Ahn Hyo-Jeong , Oh Seil , Lip Gregory Y. H. 

TITLE=Impact of components of metabolic syndrome on the risk of adverse renal outcomes in patients with atrial fibrillation: a nationwide cohort study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1208979

DOI=10.3389/fcvm.2023.1208979

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>The renal effect of metabolic syndrome components is unclear in patients with atrial fibrillation. This study aimed to investigate the association between metabolic syndrome components and incident end-stage renal disease among patients with atrial fibrillation.</p></sec><sec><title>Methods</title><p>A total of 202,434 atrial fibrillation patients without prevalent end-stage renal disease were identified from the National Health Insurance Service database between 2009 and 2016. We defined the metabolic score range from 0 to 5 points such that a patient received every 1 point if the patient met each component listed in the diagnostic criteria of metabolic syndrome. The population was divided into 6 groups: MS<sub>0</sub>–MS<sub>5</sub> for a metabolic score of 0–5, respectively. Multivariate Cox regression analysis was used to estimate the risks of end-stage renal disease.</p></sec><sec><title>Results</title><p>There were 12,747, 31,059, 40,361, 48,068, 46,630, and 23,569 patients for MS<sub>0</sub>–MS<sub>5</sub>, respectively. Compared with MS<sub>0</sub>, MS<sub>5</sub> had a higher CHA<sub>2</sub>DS<sub>2</sub>-VASc score (3.8 vs. 1.0) (<italic>P</italic> &lt; .001). During a median follow-up of 3.5 years, compared with MS<sub>0</sub>, MS<sub>1</sub>–MS<sub>5</sub> were associated with a gradually increasing incidence of end-stage renal disease, in relation to an increase in the metabolic score, (log-rank <italic>P</italic> &lt; .001). After multivariate adjustment, a higher metabolic score was associated with a greater risk of incident end-stage renal disease: adjusted hazard ratio [95% confidence interval] = 1.60 [0.78–3.48], 2.08 [1.01–4.31], 2.94 [1.43–6.06], 3.71 [1.80–7.66], and 4.82 [2.29–10.15], for MS<sub>1</sub>–MS<sub>5</sub>, respectively.</p></sec><sec><title>Conclusions</title><p>Metabolic syndrome components additively impacts the risk of incident end-stage renal disease among patients with atrial fibrillation.</p></sec>