Do changes in metabolic health and obesity affect the incidence of urolithiasis? A nationally representative cohort study

Abstract

Introduction & Objectives Metabolic health and obesity are not stable conditions, however effect of changes in the status of these conditions on urolithiasis remains unclear. In this study, we tried to determine whether changes in metabolic health and obesity affect the incidence of urolithiasis using national health screening cohort.

Materials & Methods The National Health Insurance Service-National Health Screening database was used for this study (NHIS-2022-2-156). The study cohort consisted of 514,866 health screening examinees between 2009 and 2010. Metabolic health was determined according to the modified criteria by the National Cholesterol Education Program-Adult Treatment Panel III, while obesity was determined by body mass index. Based on the results of initial (2009-2010) and second (2011-2012) health screening, the cohorts were divided according to changes in obesity and metabolic health status, after which participants were followed-up for urolithiasis from 2013 to 2020. Cox proportional hazards regression was used to determine adjusted hazard ratios (aHRs) and 95% CIs. This study was approved by Ethical Committee of the Korea University Hospital.

Results Total 265,162 of examinees who contributed a total of 1,814,200 person-years of follow up were eligible for this cohort study, during which 11,641 subjects were developed urolithiasis. Groups with persistent obese and metabolically unhealthy showed highest aHRs, whereas in groups with improved obesity or metabolic health observed lower aHRs compared to persistent groups (Table 1).

Conclusions We found maintaining metabolically healthy and normal weight or improving metabolic health and reducing weight may lead to decreased risk of urolithiasis development.