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Epidemiology and Population Health

Metabolically healthy and unhealthy obesity phenotypes and risk of renal stone: a cohort study

International Journal of Obesity volume 43, pages 852–861 (2019)Cite this article

Subjects

Abstract

Background/Objectives

Although obesity is considered an independent risk factor of nephrolithiasis, little is known about the effect of obesity on nephrolithiasis according to metabolic health status. We investigated the association between body mass index (BMI) category and the incidence of nephrolithiasis in metabolically healthy and unhealthy individuals.

Subjects/Methods

The cohort consisted of 270,190 Korean adults free of nephrolithiasis at baseline, who were followed-up annually or biennially for a median of 4.1 years. Nephrolithiasis were determined based on ultrasonographic findings. Being metabolically healthy was defined as not having any metabolic syndrome component. A parametric Cox model was used to estimate the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

During 1,415,523.0 person-years of follow-up, 13,450 participants developed nephrolithiasis (incidence rate, 9.5 per 1000 person-years). Obesity was positively associated with an increased risk of incident nephrolithiasis in dose-response manner, but the association was stronger in metabolically healthy individuals. Among metabolically healthy individuals, the multivariable-adjusted HRs (95% CIs) for incident nephrolithiasis comparing BMIs 23–24.9, 25–29.9, and ≥30 with a BMI of 18.5–22.9 kg/m2 as the reference were 1.02 (0.95–1.10), 1.12 (1.03–1.22), and 1.72 (1.21–2.44), respectively, whereas corresponding HRs (95% CIs) in metabolically unhealthy individuals were 1.10 (1.04–1.17), 1.27 (1.20–1.34), and 1.36 (1.22–1.51), respectively. The association between obesity and incident nephrolithiasis was stronger in men and current smokers.

Conclusions

Obesity was associated with a higher incidence of nephrolithiasis in both metabolically healthy and unhealthy individuals, indicating obesity per se as an independent risk factor for nephrolithiasis.

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Author information

Authors and Affiliations

  1. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Seolhye Kim, Yoosoo Chang, Kyung Eun Yun, Hyun-Suk Jung, Hocheol Shin & Seungho Ryu

  2. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yoosoo Chang & Seungho Ryu

  3. Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea

    Yoosoo Chang & Seungho Ryu

  4. Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea

    Inah Kim

  5. Division of Nephrology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Young Youl Hyun & Kyu-Beck Lee

  6. Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Kwan Joong Joo & Heung Jae Park

  7. Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Hocheol Shin

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  1. Seolhye Kim
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Correspondence to Yoosoo Chang or Seungho Ryu.

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Kim, S., Chang, Y., Yun, K.E. et al. Metabolically healthy and unhealthy obesity phenotypes and risk of renal stone: a cohort study. Int J Obes 43, 852–861 (2019). https://doi.org/10.1038/s41366-018-0140-z

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