Sex-Specific Associations Between Metabolic Patterns and Renal Function Decline: A Retrospective Cohort Study in...

To construct sex-specific metabolic patterns and investigate their effect on renal function decline among individuals without chronic kidney disease (CKD).

The subjects were from a community-based health survey in China from 2012 to 2018. 8511 eligible participants with at least three times of investigations were included. Metabolic patterns were constructed by Latent Profile Analysis based on total cholesterol, blood pressure, and fasting glucose. Renal function decline was defined as eGFR < 90 mL/[min•1.73m²]. The effect of metabolic patterns on renal function decline over time was evaluated using Generalized Estimating Equations (GEE).

Women were classified into No Metabolic Abnormalities (NMA), Hypertension-Impaired Fasting Glucose-Borderline Dyslipidemia (HIB), and Hypertension-Hyperglycemia-Borderline Dyslipidemia (HHB). Men were classified into NMA, Hypertension-Impaired Fasting Glucose-Normal Total Cholesterol (HIN), and Hypertension-Hyperglycemia-Normal Total Cholesterol (HHN). Compared to NMA, the risk of renal function decline over time was approximately 1.33 times higher in the HIB group and 1.41 times higher in the HHB group (95% CIs: 1.29-1.37 and 1.25-1.59, respectively). Consistently, these groups showed a faster eGFR decline over time than NMA. For men, the risks of renal function decline increased by 26% per year in the HIN group compared to NMA (95% CI = 1.19-1.33). No such time-dependent association was observed in the HHN group. Both HIN and HHN groups showed no significant effect on accelerated eGFR decline.

Women with HIB and HHB, and men with HIN, have an accelerated risk of renal function decline. Earlier management of metabolic abnormalities is critical for kidney protection.